Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | K9596 | TX |
NPI | 1033226006 |
---|---|
Provider Name | Zhiyong Li |
First Address | Garland, TX 75045-1326 |
Second Address | Garland, TX 75042-6682 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 10/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8691B0 | BLUE CROSS BLUE SHIELD (01) | TX |
H50227 | (02) | |
P00078008 | RAILROAD MEDICARE (01) | TX |