Individual provider Active NPI

Timothy Wong, MD

  • Pain Medicine (Anesthesiology) Physician
  • Houston, TX
National Provider Identifier
1528081866
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
H2912 Issued in TX
Practice address
1635 North Loop W
Houston, TX 77008-1532
Phone
(713) 426-1669
Fax
(713) 868-9416
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X H2912 TX Primary

Addresses

Primary practice location

1635 North Loop W
Houston, TX 77008-1532

Mailing address

PO Box 926098
Houston, TX 77292-6098
Phone (713) 426-1669

Other identifiers 1

IdentifierTypeStateIssuer
128104001MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130814000387 TX Practitioner - Anesthesiology 2668598186 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H2912TXMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physicians Network PLLC CurrentSince Jul 1, 2022 Accepting new patients
Network Anesthesia Associates PLLC Pain Medicine PastSince Mar 8, 2019 Accepting new patients
Century Integrated Partners, Inc Past Accepting new patients
Pediatric Dentistry of Keller PLLC PastSince Jul 28, 2019 Accepting new patients

Locations

3300 Oak Lawn Ave
Ste 200
Dallas, TX 75219
Phone (214) 252-3500

5858 Westheimer Rd
Ste 82
Houston, TX 77057
Phone (713) 784-6065

3800 N Shepherd Dr
Ste B
Houston, TX 77018
Phone (832) 331-2969

1627 Keller Pkwy
Ste 100
Keller, TX 76248
Phone (480) 207-9709

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1528081866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 926098",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772926098",
            "telephone_number": "713-426-1669",
            "fax_number": "713-868-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 NORTH LOOP W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081532",
            "telephone_number": "713-426-1669",
            "fax_number": "713-868-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "H2912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128104001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.