Healthcare Provider Details

I. General information

NPI: 1902875552
Provider Name (Legal Business Name): YAO J HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MLK BLVD
WICHITA FALLS TX
76301
US

IV. Provider business mailing address

200 MARTIN LUTHER KING BLVD
WICHITA FALLS TX
76301-1152
US

V. Phone/Fax

Practice location:
  • Phone: 940-766-6306
  • Fax: 940-397-2675
Mailing address:
  • Phone: 940-766-6306
  • Fax: 940-397-2675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM1429
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: