Provider Demographics
NPI:1063423689
Name:REN, YANHONG (LAC)
Entity type:Individual
Prefix:
First Name:YANHONG
Middle Name:
Last Name:REN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 CALEDONIA CREEK LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2995 LYNDON B JOHNSON FWY
Practice Address - Street 2:STE.230
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7611
Practice Address - Country:US
Practice Address - Phone:469-774-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00574171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist