Provider Demographics
NPI:1730446758
Name:LI, HUAIGUANG (MD)
Entity type:Individual
Prefix:
First Name:HUAIGUANG
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 BELLAIRE BLVD
Mailing Address - Street 2:STE 180
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3446
Mailing Address - Country:US
Mailing Address - Phone:832-834-4812
Mailing Address - Fax:832-834-4812
Practice Address - Street 1:9750 BELLAIRE BLVD
Practice Address - Street 2:SUITE 180
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3445
Practice Address - Country:US
Practice Address - Phone:832-834-4812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-15
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6858207R00000X, 208M00000X, 208M00000X
WI56802-20208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
348043Medicare PIN