MEDICARE: KIM-ANH DONNA YU PA

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	363A00000X	Physician Assistant	PA05990	TX

General Provider Information

NPI Number	:	1841441789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM-ANH DONNA YU PA

Provider Business Mailing Address
First Line	:	1316 BENTGRASS DR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75036-3925
Country	:	US
Telephone Number	:	806-681-4162
Fax Number	:

Provider Business Practice Location Address
First Line	:	3170 JUSTIN RD STE 403
Second Line	:
City	:	HIGHLAND VILLAGE
State	:	TX
Zip	:	75077-3214
Country	:	US
Telephone Number	:	972-528-4811
Fax Number	:

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

Provider Enumeration Date	:	10/09/2008
Last Update Date	:	10/10/2022

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