1144315417 NPI number — DR. ROBIN L. YUE MD

Table of content: EMILY K NETZBAND (NPI 1659871804)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144315417 NPI number — DR. ROBIN L. YUE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YUE
Provider First Name:
ROBIN
Provider Middle Name:
L.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YUE
Provider Other First Name:
LIAO
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144315417
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2021
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 210
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:
10/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  P4014 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 205342302 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".