Provider Demographics
NPI:1053952887
Name:WONG, ADINA (PHARM D)
Entity type:Individual
Prefix:MISS
First Name:ADINA
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6205 COIT RD STE 356
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5491
Mailing Address - Country:US
Mailing Address - Phone:469-543-0199
Mailing Address - Fax:469-543-0194
Practice Address - Street 1:6205 COIT RD STE 356
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5491
Practice Address - Country:US
Practice Address - Phone:469-543-0199
Practice Address - Fax:469-543-0194
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist