Provider Demographics
NPI:1083699243
Name:YOO, HARRISON WONHEE (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:WONHEE
Last Name:YOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 E SONTERRA BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4352
Mailing Address - Country:US
Mailing Address - Phone:210-404-0000
Mailing Address - Fax:201-404-2812
Practice Address - Street 1:1139 E SONTERRA BLVD
Practice Address - Street 2:SUITE #405
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4347
Practice Address - Country:US
Practice Address - Phone:210-404-0000
Practice Address - Fax:210-404-2812
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0386207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118818707Medicaid
TX8DL464OtherBCBS
P01164920OtherRAILROAD MEDICARE
TX1434185-01Medicaid
TXF67752Medicare UPIN
TXB161160Medicare PIN
P01164920OtherRAILROAD MEDICARE
TX8F9121Medicare PIN
TXH08BP58401OtherBCBS
TX1434185-01Medicaid