Individual provider Active NPI

Chun-Kwok Wong, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Shenandoah, TX
National Provider Identifier
1356439087
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
H5216 Issued in TX
Practice address
9200 Pinecroft Dr
Suite 470
Shenandoah, TX 77380-3279
Phone
(281) 719-5951
Fax
(281) 719-5958
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X H5216 TX Primary

Addresses

Primary practice location

9200 Pinecroft Dr
Suite 470
Shenandoah, TX 77380-3279

Mailing address

9200 Pinecroft Dr
Suite 470
Shenandoah, TX 77380-3279
Phone (281) 719-5951

Other identifiers 1

IdentifierTypeStateIssuer
117269405MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sadler Clinic Association Past Accepting new patients
Valley Diagnostic Clinic PA Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1356439087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 PINECROFT DR",
            "address_2": "SUITE 470",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803279",
            "telephone_number": "281-719-5951",
            "fax_number": "281-719-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 PINECROFT DR",
            "address_2": "SUITE 470",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803279",
            "telephone_number": "281-719-5951",
            "fax_number": "281-719-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CHUN-KWOK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "H5216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117269405",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.