Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP116305 | TX |
NPI | 1013192624 |
---|---|
Provider Name | Li-Ting Yang |
First Address | Plano, TX 75075-3014 |
Second Address | Dallas, TX 75254-7571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2008 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
195132901 | (05) | TX |
8Y3499 | BLUE CROSS BLUE SHIELD (01) | TX |