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General NPI Number Information
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NPI Number | 1033831912
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Entity Type | Individual
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Provider Name | XU YANG PHYSICIAN ASSISTANNT
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Gender | Male
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 590 MEDICAL CENTER ROAD FORT CAVAZOS
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City | KILLEEN
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-618-8310
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Fax |
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Provider Business Mailing Address
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Address Line | 2710 CUNNINGHAM RD UNIT 8102
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City | KILLEEN
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State | TX
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Zip | 76542-3292
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Country | US
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Telephone | 832-691-3160
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Fax |
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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 | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1198902
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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