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General NPI Number Information
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NPI Number | 1003375296
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Entity Type | Individual
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Provider Name | JERRY LIU MD
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Gender | Male
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 7777 FOREST LN STE B412
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City | DALLAS
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State | TX
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Zip | 75230-6824
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Country | US
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Telephone | 972-566-5560
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Fax | 972-566-5562
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Provider Business Mailing Address
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Address Line | 7777 FOREST LN STE B412
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City | DALLAS
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State | TX
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Zip | 75230-6824
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Country | US
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Telephone | 972-566-5560
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Fax | 972-566-5562
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | U9299
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License Number State | TX
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