MEDICARE: DR. ZANE TRISTAN YANG DDS

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	122300000X	Dentist	20180	TX

General Provider Information

NPI Number	:	1104006212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZANE TRISTAN YANG DDS

Provider Business Mailing Address
First Line	:	6609 W SAM HOUSTON PKWY S # 203
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-1607
Country	:	US
Telephone Number	:	713-773-9889
Fax Number	:	713-773-9890

Provider Business Practice Location Address
First Line	:	6609 W SAM HOUSTON PKWY S # 203
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-1607
Country	:	US
Telephone Number	:	713-773-9889
Fax Number	:	713-773-9890

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

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	11/06/2007

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