MEDICARE: DR. JINGYUAN YAO PHARMD

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	183500000X	Pharmacist	54025	TX

General Provider Information

NPI Number	:	1447854898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JINGYUAN YAO PHARMD

Provider Business Mailing Address
First Line	:	4702 IRVINGTON BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-2725
Country	:	US
Telephone Number	:	713-694-9158
Fax Number	:	713-694-0533

Provider Business Practice Location Address
First Line	:	4702 IRVINGTON BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-2725
Country	:	US
Telephone Number	:	713-694-9158
Fax Number	:	713-694-0533

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

Provider Enumeration Date	:	11/25/2020
Last Update Date	:	11/25/2020

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