Provider Demographics
NPI:1487809570
Name:LI-YU HUANG MITCHELL MD PA
Entity type:Organization
Organization Name:LI-YU HUANG MITCHELL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LI-YU
Authorized Official - Middle Name:HUANG
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-780-5655
Mailing Address - Street 1:PO BOX 7204
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75711-7204
Mailing Address - Country:US
Mailing Address - Phone:903-780-5655
Mailing Address - Fax:
Practice Address - Street 1:833 S BECKHAM AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1905
Practice Address - Country:US
Practice Address - Phone:903-780-5655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty