Individual provider Active NPI

Lin Wang, MD

  • Internal Medicine Physician
  • The Woodlands, TX
National Provider Identifier
1720075096
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L9957 Issued in TX
Practice address
3115 College Park Dr Ste 107
The Woodlands, TX 77384-4001
Phone
(936) 321-6787
Fax
(936) 321-6802
NPI assigned
Oct 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L9957 TX Primary

Addresses

Primary practice location

3115 College Park Dr Ste 107
The Woodlands, TX 77384-4001

Mailing address

3115 College Park Dr
Suite 107
The Woodlands, TX 77384-4001
Phone (936) 321-6787

Other identifiers 1

IdentifierTypeStateIssuer
176100902MedicaidTX

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
I20041109000184 TX Practitioner - Internal Medicine 5496718652 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L9957TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA CurrentSince Mar 1, 2022 Accepting new patients
Texas Oncology PA CurrentSince Mar 1, 2022 Accepting new patients
Southwest Doctors PA Past Accepting new patients
Suncoast Medical Group Inc Past Accepting new patients

Locations

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

920 Medical Plaza Dr
Ste 100
Shenandoah, TX 77380
Phone (713) 897-5655

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

6807 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 908-9555

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4066/brand/1/csg/1/fhir/r4

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720075096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DR",
            "address_2": "SUITE 107",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844001",
            "telephone_number": "936-321-6787",
            "fax_number": "936-321-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DR STE 107",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844001",
            "telephone_number": "936-321-6787",
            "fax_number": "936-321-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "LIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L9957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176100902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.