Miranda Wang

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R9700 Issued in TX

Practice address

2900 E 29TH St
Bryan, TX 77802-2622

Phone

(979) 776-8440

Fax

(877) 601-5854

NPI assigned

Mar 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Family Practice

Education

Baylor College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Aandm University System Health Science CenterGroup PAC ID 8224008644, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Texas a&M University System Health Science Center

  dba Texas A&M Physicians

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1063699312
  Medicare reassignment Care Compare group NPD
• Texas a&M University System Health Science Center

  • Rural Health Clinic/Center
  • Navasota, TX
  • NPI 1558140004
  NPD
• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  NPD (past)
• Texas a&M University System Health Science Center

  dba Texas A&M School of Dentistry

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Dallas, TX
  • NPI 1912918798
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  Care Compare affiliation
• St. Joseph Regional Health Center

  dba CHI St. Joseph Health College Station Hospital

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1053963009
  Care Compare affiliation

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623542400000",
    "number": "1508397175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8441 STATE HIGHWAY 47 STE 3115",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778073207",
            "telephone_number": "979-776-8440",
            "fax_number": "979-436-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 E 29TH ST",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022622",
            "telephone_number": "979-776-8440",
            "fax_number": "877-601-5854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-1173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "MIRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2021-06-13",
        "certification_date": "2021-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "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": "R9700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Walton
• Andrew Z Wang
• Hongbo Wang, M.D.
• Ke Wang
• Mengdi Wang, PT
• Naomi Warden, RPH
• Heather Warren, PA-C
• Shannon Lea Warren, DNP, APRN, AGACNP-BC
• Lorraine Washburn, PA-C
• Timmie Tyrone Waters

• Family Medicine Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.