Provider Demographics
NPI:1275843674
Name:YOON, HEESEOK (DC)
Entity Type:Individual
Prefix:DR
First Name:HEESEOK
Middle Name:
Last Name:YOON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BLALOCK RD
Mailing Address - Street 2:SUIT I
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-4483
Mailing Address - Country:US
Mailing Address - Phone:281-846-3782
Mailing Address - Fax:713-984-8858
Practice Address - Street 1:1400 BLALOCK RD
Practice Address - Street 2:SUITE I
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4483
Practice Address - Country:US
Practice Address - Phone:281-846-3782
Practice Address - Fax:713-984-8858
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11593111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX270177YN1ZMedicare PIN