Healthcare Provider Details

I. General information

NPI: 1235653072
Provider Name (Legal Business Name): ZHANGRUI LIANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 08/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6999 MCPHERSON RD STE 215
LAREDO TX
78041-6450
US

IV. Provider business mailing address

1502 SPIDERLILY VW
CEDAR PARK TX
78613-5542
US

V. Phone/Fax

Practice location:
  • Phone: 956-284-0990
  • Fax:
Mailing address:
  • Phone: 310-307-6556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number33427
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: