MEDICARE: JEFFREY E LIANG 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	207Q00000X	Family Medicine Physician	L4530	TX
2	207QS0010X	Sports Medicine (Family Medicine) Physician	L4530	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	250013603	OTHER	TX	RR MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7783411	OTHER	TX	AETNA PPO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8H9350	OTHER	TX	BC/BS
5	198468	OTHER	TX	AMERIGROUP
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	7783411	OTHER	TX	AETNA HMO
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	L4530	OTHER	TX	STATE LICENSE
11	P01084630	OTHER	TX	RAILROAD

General Provider Information

NPI Number	:	1437155751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY E LIANG M.D.

Provider Business Mailing Address
First Line	:	6001 HARRIS PKWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4103
Country	:	US
Telephone Number	:	817-370-6350
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 HARRIS PKWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4103
Country	:	US
Telephone Number	:	817-370-6350
Fax Number	:	817-370-6401

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	01/24/2024

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Directions to “ JEFFREY E LIANG M.D.” Practice Location

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