Provider Demographics
NPI:1447854898
Name:YAO, JINGYUAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JINGYUAN
Middle Name:
Last Name:YAO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 IRVINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-2725
Mailing Address - Country:US
Mailing Address - Phone:713-694-9158
Mailing Address - Fax:713-694-0533
Practice Address - Street 1:4702 IRVINGTON BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-2725
Practice Address - Country:US
Practice Address - Phone:713-694-9158
Practice Address - Fax:713-694-0533
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist