Provider Demographics
NPI:1346253705
Name:FANG, XIANG (AC)
Entity Type:Individual
Prefix:
First Name:XIANG
Middle Name:
Last Name:FANG
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2464
Mailing Address - Country:US
Mailing Address - Phone:956-682-4885
Mailing Address - Fax:956-618-9846
Practice Address - Street 1:4413 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2464
Practice Address - Country:US
Practice Address - Phone:956-682-4885
Practice Address - Fax:956-618-9846
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC744171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX28LQOtherBLUECROSSBLUESHIELD TX