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NPI Code Detail

MEDICARE: MARY YANG M.D.

MEDICARE: MARY YANG 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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianH9015TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1220025111OTHERTXRAILROAD MEDICARE

General Provider Information

NPI Number : 1336144393
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY YANG M.D.
Provider Business Mailing Address
First Line : PO BOX 420998
Second Line :
City : HOUSTON
State : TX
Zip : 77242-0998
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6801 EMMETT F LOWRY EXPY
Second Line :
City : TEXAS CITY
State : TX
Zip : 77591-2500
Country : US
Telephone Number : 713-481-3545
Fax Number : 713-432-0221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 03/19/2009

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