Healthcare Provider Details

I. General information

NPI: 1053304261
Provider Name (Legal Business Name): HSIAO-CHUN YU DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 S WALNUT ST SUITE 3
LAS CRUCES NM
88001-1425
US

IV. Provider business mailing address

780 S WALNUT ST SUITE 3
LAS CRUCES NM
88001-1425
US

V. Phone/Fax

Practice location:
  • Phone: 505-525-3980
  • Fax: 505-526-8529
Mailing address:
  • Phone: 505-525-3980
  • Fax: 505-526-8529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number200
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: