Healthcare Provider Details

I. General information

NPI: 1326797663
Provider Name (Legal Business Name): LOUISA YUANGAO LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YUANGAO LIU

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2871 SAINT ROSE PKWY STE 130
HENDERSON NV
89052-4806
US

IV. Provider business mailing address

2871 SAINT ROSE PKWY STE 130
HENDERSON NV
89052-4806
US

V. Phone/Fax

Practice location:
  • Phone: 702-430-5333
  • Fax: 702-430-5335
Mailing address:
  • Phone: 702-430-5333
  • Fax: 702-430-5335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number29386
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: