Basic Information
| Provider Information | |||||||||
| NPI: | 1528397122 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | YU | ||||||||
| FirstName: | WEI | ||||||||
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| Credential: | RPA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1617 HEMPHILL ST | ||||||||
| Address2: | JPS PHYSICIAN GROUP | ||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761044709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8179206245 | ||||||||
| FaxNumber: | 8179273603 | ||||||||
| Practice Location | |||||||||
| Address1: | 1617 HEMPHILL ST | ||||||||
| Address2: | JPS PHYSICIAN GROUP | ||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761044709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8179206245 | ||||||||
| FaxNumber: | 8179273603 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2009 | ||||||||
| LastUpdateDate: | 04/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA07451 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.