Healthcare Provider Details

I. General information

NPI: 1710927603
Provider Name (Legal Business Name): STEPHEN S YANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13031 WORTHAM CENTER DR
HOUSTON TX
77065
US

IV. Provider business mailing address

PO BOX 678100
DALLAS TX
75267-8100
US

V. Phone/Fax

Practice location:
  • Phone: 832-280-2500
  • Fax: 817-284-9859
Mailing address:
  • Phone: 817-284-9850
  • Fax: 817-284-9859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberM2213
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: