MEDICARE: DR. QUILLAN HUANG M.D.

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	207R00000X	Internal Medicine Physician	574141	TX

General Provider Information

NPI Number	:	1215270947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUILLAN HUANG M.D.

Provider Business Mailing Address
First Line	:	7171 BUFFALO SPEEDWAY
Second Line	:	APT 1736
City	:	HOUSTON
State	:	TX
Zip	:	77025-1424
Country	:	US
Telephone Number	:	408-439-2415
Fax Number	:

Provider Business Practice Location Address
First Line	:	7171 BUFFALO SPEEDWAY
Second Line	:	APT 1736
City	:	HOUSTON
State	:	TX
Zip	:	77025-1424
Country	:	US
Telephone Number	:	408-439-2415
Fax Number	:

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

Provider Enumeration Date	:	04/01/2013
Last Update Date	:	12/07/2016

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