Provider Demographics
NPI:1376620484
Name:YUEN, RICHARD K (PHD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:K
Last Name:YUEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 LA POSADA DRIVE
Mailing Address - Street 2:SUITE 285
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3817
Mailing Address - Country:US
Mailing Address - Phone:512-206-0808
Mailing Address - Fax:512-206-0844
Practice Address - Street 1:1016 LA POSADA DRIVE
Practice Address - Street 2:SUITE 285
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3817
Practice Address - Country:US
Practice Address - Phone:512-206-0808
Practice Address - Fax:512-206-0844
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33384103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7207LCOtherBCBS
TX202177604Medicaid
TX7207LCOtherBCBS