1669786042 NPI number — NYAN WAI PHYO MD

Table of content: NYAN WAI PHYO MD (NPI 1669786042)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669786042 NPI number — NYAN WAI PHYO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PHYO
Provider First Name:
NYAN
Provider Middle Name:
WAI
Provider Name Prefix Text:
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:
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:
1669786042
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3247
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78502-3247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-800-1820
Provider Business Mailing Address Fax Number:
956-552-6882

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 E. SAVANNAH AVE.
Provider Second Line Business Practice Location Address:
BLDG. C SUITE 201
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-800-1820
Provider Business Practice Location Address Fax Number:
956-552-6882
Provider Enumeration Date:
07/28/2010

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: 207RN0300X , with the licence number:  Q4249 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: P25318 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 351937302 . This is a "MEDICAID-CSHCN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 351937301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 435418AQ1J . This is a "MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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