Active NPI
Erica Ya-Ai Wong
- Pharmacist
- Dallas, TX
National Provider Identifier
1972279560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68687
- Practice address
- 4202 Ross Ave
Dallas, TX 75204-5116 - Phone
- (214) 584-2484
- NPI assigned
- Aug 23, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 68687 | TX | Primary |
Addresses
Primary practice location
4202 Ross Ave
Dallas, TX 75204-5116
Mailing address
810 Lake Carolyn Pkwy Apt 419
Irving, TX 75039-4185
Phone (832) 713-0103
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68687 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1972279560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 LAKE CAROLYN PKWY APT 419",
"city": "IRVING",
"state": "TX",
"postal_code": "750394185",
"telephone_number": "832-713-0103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4202 ROSS AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752045116",
"telephone_number": "214-584-2484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "ERICA",
"middle_name": "YA-AI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-23",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "68687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.