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NPI Code Detail

MEDICARE: JENNY YI WEI DONG DO

MEDICARE:   JENNY YI WEI DONG  DO
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
1390200000XStudent in an Organized Health Care Education/Training Program11021016AIN
2207Q00000XFamily Medicine PhysicianU6225TX

General Provider Information

NPI Number : 1972122174
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY YI WEI DONG DO
Provider Business Mailing Address
First Line : 13930 BELLAIRE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77083-1719
Country : US
Telephone Number : 713-773-0803
Fax Number : 713-271-5422
Provider Business Practice Location Address
First Line : 13930 BELLAIRE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77083-1719
Country : US
Telephone Number : 713-773-0803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2020
Last Update Date : 08/31/2023

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Directions to “ JENNY YI WEI DONG DO” Practice Location

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