Provider Demographics
NPI:1922165877
Name:LIU, JING MING (MD)
Entity Type:Individual
Prefix:
First Name:JING
Middle Name:MING
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 461412
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75046-1412
Mailing Address - Country:US
Mailing Address - Phone:972-788-5042
Mailing Address - Fax:972-788-5041
Practice Address - Street 1:7132 LEAMEADOW DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-5504
Practice Address - Country:US
Practice Address - Phone:972-788-5042
Practice Address - Fax:972-788-5042
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8041207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000EG516Medicaid
00EG51Medicare PIN
C18479Medicare UPIN