Provider Demographics
NPI:1124473368
Name:QUNTAO YU, MD, PA
Entity type:Organization
Organization Name:QUNTAO YU, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREDSIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QUNTAO
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-565-8188
Mailing Address - Street 1:4427 HIGHWAY 6 STE J
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4516
Mailing Address - Country:US
Mailing Address - Phone:281-565-8188
Mailing Address - Fax:281-565-8184
Practice Address - Street 1:4427 HIGHWAY 6 STE J
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4516
Practice Address - Country:US
Practice Address - Phone:281-565-8188
Practice Address - Fax:281-565-8184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0720207Q00000X, 207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty