Basic Information
| Provider Information | |||||||||
| NPI: | 1205299344 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WENG | ||||||||
| FirstName: | YAOCHUNG | ||||||||
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| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 W MAGNOLIA AVE | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761044611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177597000 | ||||||||
| FaxNumber: | 8177597027 | ||||||||
| Practice Location | |||||||||
| Address1: | 7415 LAS COLINAS BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750637569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143792700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2016 | ||||||||
| LastUpdateDate: | 06/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | BP10060824 | TX | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 207R00000X | 57.027618 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2085R0001X | T2086 | TX | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.