Provider Demographics
NPI:1528072378
Name:YEN, JULIE (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:YEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 W CAMPBELL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3595
Mailing Address - Country:US
Mailing Address - Phone:972-238-1848
Mailing Address - Fax:972-238-8735
Practice Address - Street 1:399 W CAMPBELL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3595
Practice Address - Country:US
Practice Address - Phone:972-238-1848
Practice Address - Fax:972-238-8735
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine