1497310684 NPI number — CARDIOLOGY CLINIC ROBIN YUE MD PLLC

Table of content: (NPI 1497310684)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497310684 NPI number — CARDIOLOGY CLINIC ROBIN YUE MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIOLOGY CLINIC ROBIN YUE MD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CARDIOLOGY CLINIC OF EL CAMPO
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497310684
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 271962
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77277-1962
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-837-0731
Provider Business Mailing Address Fax Number:
888-833-1680

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
305 SANDY CORNER RD STE 230
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL CAMPO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77437-9535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-578-5228
Provider Business Practice Location Address Fax Number:
979-578-5103
Provider Enumeration Date:
05/03/2019

Additional Information

Authorized Official

Authorized Official Last Name:
YUE
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
OWNER AND PHYSICIAN
Authorized Official Telephone Number:
858-837-0731

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 400360001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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