Provider Demographics
NPI:1497840235
Name:TAYU HUANG MD LTD
Entity Type:Organization
Organization Name:TAYU HUANG MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:TAYU
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-757-8010
Mailing Address - Street 1:204 SERIO BLVD
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334
Mailing Address - Country:US
Mailing Address - Phone:318-757-8010
Mailing Address - Fax:318-757-8010
Practice Address - Street 1:204 SERIO BLVD
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334
Practice Address - Country:US
Practice Address - Phone:318-757-8010
Practice Address - Fax:318-757-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD03721R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1156591Medicaid
E06868Medicare UPIN
LA1156591Medicaid