Provider Demographics
NPI:1295825784
Name:NIEMAN, YEN DANG (MD)
Entity Type:Individual
Prefix:DR
First Name:YEN
Middle Name:DANG
Last Name:NIEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NGOC-YEN
Other - Middle Name:THI
Other - Last Name:DANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5717 BALCONES DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4203
Mailing Address - Country:US
Mailing Address - Phone:512-327-7000
Mailing Address - Fax:512-314-1660
Practice Address - Street 1:5717 BALCONES DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-327-7000
Practice Address - Fax:512-314-1660
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4146207W00000X
TXL6337207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7786876OtherAETNA
VP17868OtherGE WELLNESS
32951-023OtherDAVIS VISION
H86666Medicare UPIN
TX8J0999Medicare PIN
SCP00475499Medicare PIN
930447OtherBLOCK VISION
TX6337OtherEYEMED
55343-006OtherDAVIS VISION
01038910OtherAMERIGROUP
152572100OtherFIRST CARE
4286666OtherBLUELINK
TX80369SOtherBLUE CROSS BLUE SHIELD
TX1592990-07Medicaid