Individual provider Active NPI

Veenadhari Wang, MD

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1477094878
Registry record updated Sep 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T0743 Issued in TX
Practice address
6624 Fannin St FL 20
Houston, TX 77030-2312
Phone
(713) 798-7700
NPI assigned
Mar 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X T0743 TX
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2022015059 MO
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X T0743 TX Primary

Addresses

Primary practice location

6624 Fannin St FL 20
Houston, TX 77030-2312

Mailing address

3701 Kirby Dr Ste 600
Houston, TX 77098-3926
Phone (713) 798-4491

Other practice location 1

1225 S Grand Blvd Fl 2
Saint Louis, MO 63104-1016
Phone (314) 977-4440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220617000171 MO Practitioner - Geriatric MedicinePractitioner - Internal Medicine 2961881222 Reassigns benefits to 1 organization
I20231004003271 TX Practitioner - Family PracticePractitioner - Geriatric Medicine 2961881222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

6624 Fannin St
FL 20
Houston, TX 77030-2312
Phone (713) 798-7700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T0743TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care Group Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
SSM Medical Group Inc. PastSince May 1, 2022 Accepting new patients

Locations

1225 S Grand Blvd
Fl 2
Saint Louis, MO 63104
Phone (314) 617-2355

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

Interoperability endpoints

  • Direct secure messaging: vchavakula424810@direct-ehr-ssmhc.com

Organizations & group practices 4

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": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695513600000",
    "number": "1477094878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 KIRBY DR STE 600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983926",
            "telephone_number": "713-798-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 FANNIN ST FL 20",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302312",
            "telephone_number": "713-798-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 S Grand Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041016",
            "country_code": "US",
            "telephone_number": "314-977-4440",
            "fax_number": "314-977-5123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "VEENADHARI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-17",
        "last_updated": "2023-09-24",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "T0743",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2022015059",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T0743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.