MEDICARE: DR. YONG DU 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	207RN0300X	Nephrology Physician	L3286	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538153259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YONG DU M.D.

Provider Business Mailing Address
First Line	:	605 E SAN ANTONIO ST
Second Line	:	SUITE 430E
City	:	VICTORIA
State	:	TX
Zip	:	77901-6050
Country	:	US
Telephone Number	:	361-576-0011
Fax Number	:	361-576-4084

Provider Business Practice Location Address
First Line	:	605 E SAN ANTONIO ST
Second Line	:	SUITE 430E
City	:	VICTORIA
State	:	TX
Zip	:	77901-6050
Country	:	US
Telephone Number	:	361-576-0011
Fax Number	:	361-576-4084

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	01/30/2014

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