Healthcare Provider Details

I. General information

NPI: 1528206901
Provider Name (Legal Business Name): JONATHAN ALEXANDER YANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W 40TH ST
AUSTIN TX
78756-4010
US

IV. Provider business mailing address

2186 JACKSON KELLER RD # 3116
SAN ANTONIO TX
78213-2723
US

V. Phone/Fax

Practice location:
  • Phone: 512-483-6807
  • Fax:
Mailing address:
  • Phone: 512-815-3630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberQ6801
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: