Provider Demographics
NPI:1992236707
Name:LIN, BIXUAN (MD)
Entity type:Individual
Prefix:
First Name:BIXUAN
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:700 OLYMPIC PLAZA CIR STE 410
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1952
Mailing Address - Country:US
Mailing Address - Phone:903-531-8950
Mailing Address - Fax:
Practice Address - Street 1:700 OLYMPIC PLAZA CIR STE 410
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1952
Practice Address - Country:US
Practice Address - Phone:903-531-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT9170207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology