| Yan Li, Md., Phd., P.a. | |
|
4040 Mcdermott Rd Suite 100 Plano TX 75024-7734 | |
| (972) 668-6868 | |
| (972) 668-1618 |
| Full Name | Yan Li, Md., Phd., P.a. |
|---|---|
| Speciality | Contractor |
| Location | 4040 Mcdermott Rd, Plano, Texas |
| Authorized Official Name and Position | Jennifer Li (OFFICE MANAGER) |
| Authorized Official Contact | 9726686868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yan Li, Md., Phd., P.a. 4040 Mcdermott Rd Suite 100 Plano TX 75024-7734 Ph: (972) 668-6868 | Yan Li, Md., Phd., P.a. 4040 Mcdermott Rd Suite 100 Plano TX 75024-7734 Ph: (972) 668-6868 |
| NPI Number | 1093990079 |
|---|---|
| Provider Enumeration Date | 01/08/2008 |
| Last Update Date | 03/21/2024 |
| Medicare PECOS PAC ID | 8224920228 |
|---|---|
| Medicare Enrollment ID | O20040325001182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093990079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 171W00000X | Contractor | K1863 (Texas) | Primary |
| Provider Name | Yan Li |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619932076 PECOS PAC ID: 7911899927 Enrollment ID: I20040325001344 |
| Provider Name | Stephanie E Stafford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720031321 PECOS PAC ID: 6507820792 Enrollment ID: I20041117000574 |
| Provider Name | Kyoko Arata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790234482 PECOS PAC ID: 8628353992 Enrollment ID: I20170329000558 |
| Provider Name | Chuangmin Wu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427411099 PECOS PAC ID: 6901286541 Enrollment ID: I20220629001637 |
Jeffrey C. Komenda, M.d., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5944 W Parker Rd, Suite 100, Plano, TX 75093 Phone: 972-608-1868 Fax: 972-943-8644 | |
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Michelle Sun Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3900 W 15th St, Suite 404, Plano, TX 75075 Phone: 972-758-9327 Fax: 972-867-4970 | |
William R Sheldon, Jr., Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5930 W Parker Rd, #700, Plano, TX 75093 Phone: 972-943-7626 Fax: 972-608-5223 | |
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