Individual
JEFFREY E LIANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6001 HARRIS PKWY, FORT WORTH, TX 76132-4103
(817) 370-6350
(817) 370-6401
Mailing address
6001 HARRIS PKWY, FORT WORTH, TX 76132-4103
(817) 370-6350
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
L4530
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
L4530
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161325901
—
TX
05
—
161325902
—
TX
05
—
161325903
—
TX
05
—
161325904
—
TX
01
—
198468
AMERIGROUP
TX
01
—
250013603
RR MEDICARE NUMBER
TX
01
—
7783411
AETNA PPO
TX
01
—
8H9350
BC/BS
TX
01
—
L4530
STATE LICENSE
TX
01
—
P01084630
RAILROAD
TX
Enumeration date
06/22/2005
Last updated
01/24/2024
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