MEDICARE: DR. YANFENG SHI DPT

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	225100000X	Physical Therapist	1196532	TX

General Provider Information

NPI Number	:	1871812172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YANFENG SHI DPT

Provider Business Mailing Address
First Line	:	1806 RALSTON BRANCH WAY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4566
Country	:	US
Telephone Number	:	832-520-9229
Fax Number	:

Provider Business Practice Location Address
First Line	:	1806 RALSTON BRANCH WAY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4566
Country	:	US
Telephone Number	:	832-520-9229
Fax Number	:

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

Provider Enumeration Date	:	05/26/2010
Last Update Date	:	01/20/2020

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