Provider Demographics
NPI:1710926308
Name:ZHAO, YING (MD)
Entity Type:Individual
Prefix:
First Name:YING
Middle Name:
Last Name:ZHAO
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 1:810 LUCAS DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-3446
Mailing Address - Country:US
Mailing Address - Phone:903-675-6778
Mailing Address - Fax:903-675-2333
Practice Address - Street 1:810 LUCAS DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-3446
Practice Address - Country:US
Practice Address - Phone:903-675-6778
Practice Address - Fax:903-675-2333
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM06162085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K7027Medicare PIN
TXP00365150Medicare PIN
TXB113479Medicare PIN
I25352Medicare UPIN