Healthcare Provider Details
I. General information
NPI: 1215513700
Provider Name (Legal Business Name): JANE LIANG ZHU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/23/2021
Last Update Date: 06/25/2025
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 S MAIN ST
FORT WORTH TX
76104-4917
US
IV. Provider business mailing address
8201 PRESTON ROAD SUITE #350
DALLAS TX
75225
US
V. Phone/Fax
- Phone: 817-702-1244
- Fax:
- Phone: 214-631-7546
- Fax: 214-631-8546
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | V5000 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: