MEDICARE: DR. YI-HSUAN EMMY WU 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	207Y00000X	Otolaryngology Physician	Q2414	TX

General Provider Information

NPI Number	:	1447413901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YI-HSUAN EMMY WU M.D.

Provider Business Mailing Address
First Line	:	6611 RIVER PLACE BLVD STE 301
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78730-1162
Country	:	US
Telephone Number	:	512-677-6368
Fax Number	:	512-687-1477

Provider Business Practice Location Address
First Line	:	6611 RIVER PLACE BLVD STE 304
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78730-1162
Country	:	US
Telephone Number	:	512-677-6368
Fax Number	:

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

Provider Enumeration Date	:	07/04/2008
Last Update Date	:	11/30/2022

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