Provider Demographics
NPI:1033226006
Name:LI, ZHIYONG (MD)
Entity Type:Individual
Prefix:
First Name:ZHIYONG
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 451326
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75045-1326
Mailing Address - Country:US
Mailing Address - Phone:972-487-8866
Mailing Address - Fax:972-487-8190
Practice Address - Street 1:315 N SHILOH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6682
Practice Address - Country:US
Practice Address - Phone:972-487-8866
Practice Address - Fax:972-487-8190
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK9596207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00078008OtherRAILROAD MEDICARE
TX8691B0OtherBLUE CROSS BLUE SHIELD
H50227Medicare UPIN
TX8691B0OtherBLUE CROSS BLUE SHIELD