Provider Demographics
NPI:1346526381
Name:YAN YAN CHENG, MD, PA
Entity Type:Organization
Organization Name:YAN YAN CHENG, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAN YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-370-0015
Mailing Address - Street 1:4630 50TH ST
Mailing Address - Street 2:SUITE 506-A
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-3521
Mailing Address - Country:US
Mailing Address - Phone:806-370-0015
Mailing Address - Fax:866-867-8390
Practice Address - Street 1:4630 50TH ST
Practice Address - Street 2:SUITE 506-A
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3521
Practice Address - Country:US
Practice Address - Phone:806-370-0015
Practice Address - Fax:866-867-8390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD235922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty