Provider Demographics
NPI:1629001318
Name:OUYANG, LUKE Y (MD)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:Y
Last Name:OUYANG
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 1:12950 DALLAS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4235
Mailing Address - Country:US
Mailing Address - Phone:972-377-8695
Mailing Address - Fax:
Practice Address - Street 1:12950 DALLAS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4235
Practice Address - Country:US
Practice Address - Phone:972-377-8695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175762701Medicaid
TX175762702Medicaid
TX175762701Medicaid
TX175762702Medicaid
TXTXB123283Medicare PIN