Healthcare Provider Details
I. General information
NPI: 1447463898
Provider Name (Legal Business Name): DONNA D YI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/08/2007
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3701 KIRBY DR SUITE 790
HOUSTON TX
77098-3900
US
IV. Provider business mailing address
3701 KIRBY DR SUITE 790
HOUSTON TX
77098-3900
US
V. Phone/Fax
- Phone: 832-582-8268
- Fax: 832-582-8656
- Phone: 832-582-8268
- Fax: 832-582-8656
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | L0718 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: