1821329897 NPI number — STEPHEN YANG, M.D., P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821329897 NPI number — STEPHEN YANG, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEPHEN YANG, M.D., P.A.
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:
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:
1821329897
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4771 SWEETWATER BLVD
Provider Second Line Business Mailing Address:
SUITE #254
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77479-3121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-834-3888
Provider Business Mailing Address Fax Number:
713-422-2559

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1325 HIGHWAY 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77478-4906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-834-3888
Provider Business Practice Location Address Fax Number:
713-422-2559
Provider Enumeration Date:
01/14/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
YANG
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-834-3888

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  M2213 , 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: 212814201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0085TM . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".