Provider Demographics
NPI:1558370221
Name:YEO, NANCY MUI-YOUNG (DO)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:MUI-YOUNG
Last Name:YEO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 S BUCKNER BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-4304
Mailing Address - Country:US
Mailing Address - Phone:214-398-8950
Mailing Address - Fax:214-398-8952
Practice Address - Street 1:1143 S BUCKNER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-4304
Practice Address - Country:US
Practice Address - Phone:214-398-8950
Practice Address - Fax:214-398-8952
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1145207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092083701Medicaid
TX092083702Medicaid
TX092083701Medicaid
0020AAMedicare ID - Type Unspecified