Provider Demographics
NPI:1902123698
Name:YEUNG, TERRY (DO)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:YEUNG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 S US HIGHWAY 75 STE 300
Mailing Address - Street 2:ATTN. BILLING
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4589
Mailing Address - Country:US
Mailing Address - Phone:903-416-6090
Mailing Address - Fax:903-416-6091
Practice Address - Street 1:5012 S US HIGHWAY 75
Practice Address - Street 2:SUITE 230
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4634
Practice Address - Country:US
Practice Address - Phone:903-416-6090
Practice Address - Fax:903-416-6091
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9096208200000X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8GC506OtherBCBS OF TX
TX3609703-01Medicaid
TX519804YSYFMedicare PIN