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General NPI Number Information
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NPI Number | 1669047791
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Entity Type | Individual
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Provider Name | XIN FANG
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Gender | Female
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 1901 W EXPY 83 STE 800
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City | WESLACO
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State | TX
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Zip | 78596-4348
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Country | US
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Telephone | 956-277-2413
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Fax |
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Provider Business Mailing Address
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Address Line | 1039 GREENWOOD DR
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City | MENLO PARK
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State | CA
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Zip | 94025-1756
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 37867
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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