Healthcare Provider Details

I. General information

NPI: 1124473368
Provider Name (Legal Business Name): QUNTAO YU, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4427 HIGHWAY 6 STE J
SUGAR LAND TX
77478-4516
US

IV. Provider business mailing address

4427 HIGHWAY 6 STE J
SUGAR LAND TX
77478-4516
US

V. Phone/Fax

Practice location:
  • Phone: 281-565-8188
  • Fax: 281-565-8184
Mailing address:
  • Phone: 281-565-8188
  • Fax: 281-565-8184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL0720
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL0720
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL0720
License Number StateTX

VIII. Authorized Official

Name: DR. QUNTAO YU
Title or Position: PREDSIDENT
Credential: MD
Phone: 281-565-8188