Provider Demographics
NPI:1588846638
Name:LIU, YUAN CHAO (MD,/PHD (CHINA))
Entity Type:Individual
Prefix:DR
First Name:YUAN CHAO
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD,/PHD (CHINA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6502 BANDERA RD STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1445
Mailing Address - Country:US
Mailing Address - Phone:210-647-1305
Mailing Address - Fax:210-573-4315
Practice Address - Street 1:6502 BANDERA RD STE 108
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1445
Practice Address - Country:US
Practice Address - Phone:210-647-1305
Practice Address - Fax:210-573-4315
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00204171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPROVIDER ID# 1837170OtherCOVENTRY HEALTH CARE
TX10775479OtherCAQH