MEDICARE: DR. MICHAEL YUEYANG ZHAO

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	207Q00000X	Family Medicine Physician	R5491	TX

General Provider Information

NPI Number	:	1598128639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL YUEYANG ZHAO

Provider Business Mailing Address
First Line	:	2601 HOSPITAL BLVD
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78405-1815
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 HOSPITAL BLVD STE 113
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78405-1876
Country	:	US
Telephone Number	:	361-902-4789
Fax Number	:

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

Provider Enumeration Date	:	04/05/2016
Last Update Date	:	10/18/2024

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