Provider Demographics
NPI:1437136520
Name:YU, ADAM J (MD)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:J
Last Name:YU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 E MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5500
Mailing Address - Country:US
Mailing Address - Phone:903-315-2740
Mailing Address - Fax:903-315-2742
Practice Address - Street 1:703 E MARSHALL AVE
Practice Address - Street 2:STE 3008
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5500
Practice Address - Country:US
Practice Address - Phone:903-315-2740
Practice Address - Fax:903-315-2742
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1147207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116460004Medicaid