Healthcare Provider Details

I. General information

NPI: 1740483924
Provider Name (Legal Business Name): JANE LU YAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 PARK CENTRAL DR STE 410
DALLAS TX
75251-2101
US

IV. Provider business mailing address

800 W MAGNOLIA AVE
FORT WORTH TX
76104-4611
US

V. Phone/Fax

Practice location:
  • Phone: 972-490-5970
  • Fax:
Mailing address:
  • Phone: 817-759-7000
  • Fax: 817-759-7027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberM1410
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberM1410
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: