Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | H4988 | TX |
NPI | 1003886409 |
---|---|
Provider Name | Jean H Liu |
First Address | San Antonio, TX 78229-3824 |
Second Address | San Antonio, TX 78258-4347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
124300806 | (05) | TX |
8CM508 | BCBS (01) | TX |
E81488 | (02) | TX |
P00898257 | RAILROAD MEDICARE (01) | TX |
TXB112504 | MEDICARE (01) | TX |