| Doctor Name: | DR. YU TANG JAMES SU |
| NPI Number: | 1932135043 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | J6751 |
| Business Practice Address: | 2103 E Griffin Pkwy Suite B Mission, TX - 785723489 |
| Business Phone Number: | 9562714719 |
| Business Fax Number: | 9562714717 |
| Mailing Address: | 2103 E Griffin Pkwy, Suite B MISSION |
| State: | TX |
| Postal Code: | 785723489 |
| Phone Number: | 9562714719 |
| Fax Number: | 9562714717 |
| NPI Enumeration Date: | 06/23/2006 |
| NPI Last Update Date: | 06/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | J6751 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |