1639319106 NPI number — DR. ZHONG JING YANG PHYSICIAN ASSIST

Table of content: DR. ZHONG JING YANG PHYSICIAN ASSIST (NPI 1639319106)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639319106 NPI number — DR. ZHONG JING YANG PHYSICIAN ASSIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YANG
Provider First Name:
ZHONG JING
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICIAN ASSIST
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1639319106
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10023 MAIN ST
Provider Second Line Business Mailing Address:
STE C9
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77025-5252
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-791-1633
Provider Business Mailing Address Fax Number:
713-791-1633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9320 WESTWOOD VILLAGE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77036-8733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-435-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/24/2009

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: 363A00000X , with the licence number:  PA00481 , 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)





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