Provider Demographics
NPI:1841269958
Name:LIU, GEORGE T (DPM)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:T
Last Name:LIU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 INWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7202
Mailing Address - Country:US
Mailing Address - Phone:214-645-5713
Mailing Address - Fax:214-645-3301
Practice Address - Street 1:INWOOD RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8882
Practice Address - Country:US
Practice Address - Phone:214-645-5713
Practice Address - Fax:214-645-3301
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1594213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161472901Medicaid
TXU96919Medicare UPIN
TX8B1704Medicare PIN
TX161472901Medicaid