Provider Demographics
NPI:1417993114
Name:GU, YUFANG (FNP)
Entity Type:Individual
Prefix:
First Name:YUFANG
Middle Name:
Last Name:GU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7460 WARREN PKWY STE 160
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4170
Mailing Address - Country:US
Mailing Address - Phone:469-556-5048
Mailing Address - Fax:972-492-2617
Practice Address - Street 1:4120 MANGROVE DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1477
Practice Address - Country:US
Practice Address - Phone:469-556-5048
Practice Address - Fax:972-492-2617
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX624601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y0151OtherBCBS
TX178852302Medicaid
TXD07564OtherMEDICARE RR PALMETTO
TXDQ5280OtherMEDICARE RR PALMETTO
TX178852303Medicaid
TX178852303Medicaid
TXP00324123Medicare PIN
TXTXB100867Medicare PIN
TXD07564OtherMEDICARE RR PALMETTO
TX178852302Medicaid
TX8L18872Medicare PIN
TX8G3765Medicare PIN