Provider Demographics
NPI:1801126735
Name:YU, GREGORY GUO (MD, PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:GUO
Last Name:YU
Suffix:
Gender:M
Credentials:MD, PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3154 SE MILITARY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3975
Mailing Address - Country:US
Mailing Address - Phone:210-337-0911
Mailing Address - Fax:
Practice Address - Street 1:3154 SE MILITARY DR STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3975
Practice Address - Country:US
Practice Address - Phone:210-337-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS4421207P00000X
TX47460183500000X
DCMD047549207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program