Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101250846 | VA |
N | 111NI0900X | Internist | 0101250846 | VA |
Y | 207RG0100X | Gastroenterologist | 0101250846 | VA |
NPI | 1033430913 |
---|---|
Provider Name | Dr. Yang Liu |
First Address | San Antonio, TX 78234-4504 |
Second Address | San Antonio, TX 78234-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2010 |
Last Update Date | 02/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033430913 | UNITED STATES AIR FORCE (01) |