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General NPI Number Information
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NPI Number | 1447678958
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Entity Type | Individual
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Provider Name | SIDA YAN MD
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Gender | Female
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 5755 NW LOOP 410 STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78238-2502
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Country | US
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Telephone | 210-963-8445
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Fax | 210-520-0149
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Provider Business Mailing Address
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Address Line | 3206 ROAN WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78259-2221
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Country | US
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Telephone | 314-601-2796
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R0815
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License Number State | TX
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