MEDICARE: YILI WANG 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	K2817	TX

General Provider Information

NPI Number	:	1376640789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YILI WANG M.D.

Provider Business Mailing Address
First Line	:	8210 WALNUT HILL LN
Second Line	:	STE 230
City	:	DALLAS
State	:	TX
Zip	:	75231-4488
Country	:	US
Telephone Number	:	214-265-8646
Fax Number	:	214-361-1939

Provider Business Practice Location Address
First Line	:	8210 WALNUT HILL LN
Second Line	:	STE 230
City	:	DALLAS
State	:	TX
Zip	:	75231-4488
Country	:	US
Telephone Number	:	972-284-7000
Fax Number	:	972-284-7001

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/24/2018

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