Healthcare Provider Details

I. General information

NPI: 1679583082
Provider Name (Legal Business Name): WEIBIN YANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 W SPRING CREEK PKWY STE 200
PLANO TX
75024-5204
US

IV. Provider business mailing address

PO BOX 262671
PLANO TX
75026-2671
US

V. Phone/Fax

Practice location:
  • Phone: 972-378-1348
  • Fax: 888-789-6471
Mailing address:
  • Phone: 214-857-1437
  • Fax: 214-857-1281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberN1498
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number36-100971
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: