Healthcare Provider Details

I. General information

NPI: 1336995562
Provider Name (Legal Business Name): LYNDON HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 RED RIVER ST FL 2
AUSTIN TX
78712-1845
US

IV. Provider business mailing address

1501 RED RIVER ST FL 2
AUSTIN TX
78712-1845
US

V. Phone/Fax

Practice location:
  • Phone: 512-495-5555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP10088148
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: