MEDICARE: MICHAEL LIU DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	M4300	TX
2	208100000X	Physical Medicine & Rehabilitation Physician	M4300	TX

General Provider Information

NPI Number	:	1043331903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL LIU DO

Provider Business Mailing Address
First Line	:	5811 GRAYSON CV
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-5666
Country	:	US
Telephone Number	:	817-845-2312
Fax Number	:

Provider Business Practice Location Address
First Line	:	5720 BANDERA RD
Second Line	:	SUITE 14
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1985
Country	:	US
Telephone Number	:	817-845-2312
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	06/05/2013

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