Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 047873 | GA |
Y | 207T00000X | Neurosurgeon | M6970 | TX |
NPI | 1083666978 |
---|---|
Provider Name | Yi Jonathan Zhang |
First Address | Houston, TX 77030-2706 |
Second Address | Houston, TX 77030-2706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 12/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
188567501 | (05) | TX |
188567502 | (05) | TX |
188567503 | (05) | TX |
8EB171 | BLUE CROSS BLUE SHIELD (01) | TX |
8R9789 | BLUE CROSS BLUE SHIELD (01) | TX |
I31367 | (02) | TX |
P00442043 | RAILROAD MEDICARE (01) | TX |
P01331458 | RR MEDICARE (01) | TX |