Basic Information
| Provider Information | |||||||||
| NPI: | 1518445451 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZHENG | ||||||||
| FirstName: | XUELIAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2119 GROVE PARK LN | ||||||||
| Address2: | |||||||||
| City: | RICHARDSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750808405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166270915 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9846 HWY 31 E | ||||||||
| Address2: | |||||||||
| City: | TYLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757052329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035258001 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2018 | ||||||||
| LastUpdateDate: | 09/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | 26382 | TX | Y | Nursing Service Providers | Licensed Vocational Nurse |
ID Information
| ID | Type | State | Issuer | Description | NA | 01 | NA | OTHER |