Provider Demographics
NPI:1619062254
Name:ZHANG, FANGYI (MD)
Entity Type:Individual
Prefix:PROF
First Name:FANGYI
Middle Name:
Last Name:ZHANG
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:P O BOX 201088
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-1088
Mailing Address - Country:US
Mailing Address - Phone:713-500-3500
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST
Practice Address - Street 2:1020
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3000
Practice Address - Country:US
Practice Address - Phone:832-325-7080
Practice Address - Fax:713-512-2238
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8452207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AR788OtherBCBSTX
TX183716301Medicaid
TX183716302Medicaid
TX8B8796OtherBCBSTX
I33049Medicare UPIN
TXP00373794Medicare PIN
TX183716302Medicaid
TX183716301Medicaid
TX8K9916Medicare PIN