Provider Demographics
NPI:1922079698
Name:LI, YUJING
Entity Type:Individual
Prefix:
First Name:YUJING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6609 W SAM HOUSTON PKWY S
Mailing Address - Street 2:STE 102
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-1641
Mailing Address - Country:US
Mailing Address - Phone:713-595-9000
Mailing Address - Fax:713-595-8500
Practice Address - Street 1:2727 W HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025
Practice Address - Country:US
Practice Address - Phone:713-790-9412
Practice Address - Fax:713-790-9738
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4529208VP0000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153105501Medicaid
TX84P232Medicare ID - Type Unspecified
TX153105501Medicaid