Provider Demographics
NPI:1821086968
Name:YANG, SHIWEN Z (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SHIWEN
Middle Name:Z
Last Name:YANG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 GEDDINGTON
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2063
Mailing Address - Country:US
Mailing Address - Phone:210-408-1637
Mailing Address - Fax:210-732-2390
Practice Address - Street 1:333 N SANTA ROSA AVE
Practice Address - Street 2:PATH DEPT
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-735-9461
Practice Address - Fax:210-736-3835
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3199207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H62577Medicare UPIN
87779HMedicare ID - Type Unspecified