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Tony Wong Leung

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NPI Number Detailed Information

Provider Information:

Name: Tony Wong Leung
Gender: M
Provider License Number If Given: 07961R

NPI Information:

NPI: 1881693463
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 12/5/2011

Provider Business Mailing Address:

Address: PO BOX 6574
Lake Charles, LA 70606
Phone Number: 3374970366
Fax Number: 3374971367

Provider Business Practice Location Address:

Address: 105 S RYAN ST
Lake Charles, LA 70601
Phone Number: 3374970366
Fax Number: 3374971367

Provider Taxonomy:

Primary: 207RN0300X
Secondary (if any):
State: LA

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