MEDICARE: DR. LISA BEIWEI ZHANG 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	207N00000X	Dermatology Physician	4301115104	MI
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207N00000X	Dermatology Physician	S7586	TX

General Provider Information

NPI Number	:	1376962175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA BEIWEI ZHANG M.D.

Provider Business Mailing Address
First Line	:	11511 SHADOW CREEK PKWY
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7298
Country	:	US
Telephone Number	:	713-442-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 BEECHNUT ST STE 290
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-4311
Country	:	US
Telephone Number	:	713-771-8941
Fax Number	:

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

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	11/07/2022

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