Healthcare Provider Details

I. General information

NPI: 1386689172
Provider Name (Legal Business Name): PHILBERT T YAU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 EVERGREEN CIR
THE WOODLANDS TX
77380-3602
US

IV. Provider business mailing address

1055 EVERGREEN CIR
THE WOODLANDS TX
77380-3602
US

V. Phone/Fax

Practice location:
  • Phone: 281-363-3560
  • Fax:
Mailing address:
  • Phone: 281-363-3560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM0980
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM0980
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: