Individual
XIAOTUAN ZHAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 E HOUSTON ST STE 550, TYLER, TX 75702-8366
(903) 606-8718
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M2221
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175894801
—
TX
05
—
175894805
—
TX
01
—
901094
MEDICARE
TX
01
—
P02416492
MEDICARE RAIL ROAD
TX
Enumeration date
12/13/2005
Last updated
05/27/2020
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