Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | Q9096 | TX |
N | 208200000X | Surgeon | Q9096 | TX |
N | 208600000X | Surgeon | Q9096 | TX |
NPI | 1902123698 |
---|---|
Provider Name | Terry Yeung |
First Address | Denison, TX 75020-4589 |
Second Address | Denison, TX 75020-4634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2010 |
Last Update Date | 09/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3609703-01 | (05) | TX |
8GC506 | BCBS OF TX (01) | TX |