Provider Demographics
NPI:1295162766
Name:HUANG, MARY YIMEI (PA-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:YIMEI
Last Name:HUANG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN STE C135
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-6825
Mailing Address - Country:US
Mailing Address - Phone:972-347-4783
Mailing Address - Fax:972-347-4916
Practice Address - Street 1:4510 MEDICAL CENTER DR STE 301
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1603
Practice Address - Country:US
Practice Address - Phone:972-347-4783
Practice Address - Fax:972-347-4916
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08742363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX471098YM5CMedicare PIN
TX348144ZGGBMedicare PIN