MEDICARE: YVETTE YAN JIANG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	T3104	TX

General Provider Information

NPI Number	:	1063943868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVETTE YAN JIANG M.D.

Provider Business Mailing Address
First Line	:	1400 GEORGE DIETER DR STE 240
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7658
Country	:	US
Telephone Number	:	915-910-6700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 GEORGE DIETER DR STE 240
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7658
Country	:	US
Telephone Number	:	159-910-6700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2017
Last Update Date	:	11/29/2022

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