Provider Demographics
NPI:1285114256
Name:YU, MARK
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 SHADYWOOD LN
Mailing Address - Street 2:APT 28
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-5642
Mailing Address - Country:US
Mailing Address - Phone:325-500-1287
Mailing Address - Fax:
Practice Address - Street 1:2003 N EDWARDS AVE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2010
Practice Address - Country:US
Practice Address - Phone:903-572-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-18
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist