Doctor Name: | MICHAEL LIU |
NPI Number: | 1043331903 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | M4300 |
Business Practice Address: | 5720 Bandera Rd Suite 14 San Antonio, TX - 782381985 |
Business Phone Number: | 8178452312 |
Business Fax Number: | |
Mailing Address: | 5811 Grayson Cv, SAN ANTONIO |
State: | TX |
Postal Code: | 782535666 |
Phone Number: | 8178452312 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 06/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | M4300 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |