MEDICARE: XUDONG XU 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	207Q00000X	Family Medicine Physician	L9967	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8M8351	OTHER	BCBS
3	7311578	OTHER	AETNA

General Provider Information

NPI Number	:	1992701908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XUDONG XU M.D.

Provider Business Mailing Address
First Line	:	9160 BELLAIRE BLVD
Second Line	:	STE E
City	:	HOUSTON
State	:	TX
Zip	:	77036-4632
Country	:	US
Telephone Number	:	713-995-8886
Fax Number	:	713-270-9358

Provider Business Practice Location Address
First Line	:	9160 BELLAIRE BLVD
Second Line	:	SUITE E
City	:	HOUSTON
State	:	TX
Zip	:	77036
Country	:	US
Telephone Number	:	713-995-8886
Fax Number	:	713-270-9358

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	09/30/2018

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Directions to “ XUDONG XU M.D.” Practice Location

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