Individual
IN JA YI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-5306
(214) 590-2798
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
523322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041561402
—
TX
05
—
041561403
—
TX
05
—
041561404
—
TX
05
—
041561405
—
TX
05
—
041561406
—
TX
05
—
041561407
—
TX
05
—
041561408
—
TX
05
—
041561409
—
TX
05
—
041561410
—
TX
05
—
041561411
—
TX
05
—
041561412
—
TX
05
—
041561413
—
TX
01
—
8N4775
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/28/2005
Last updated
04/14/2009
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