Provider Demographics
NPI:1619068186
Name:CHIN, YONG U (MD)
Entity Type:Individual
Prefix:
First Name:YONG
Middle Name:U
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YONG
Other - Middle Name:UK
Other - Last Name:CHIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-0189
Mailing Address - Country:US
Mailing Address - Phone:254-562-9321
Mailing Address - Fax:254-562-3570
Practice Address - Street 1:600 S BONHAM ST
Practice Address - Street 2:SUITE G
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-3603
Practice Address - Country:US
Practice Address - Phone:254-562-9321
Practice Address - Fax:254-562-3570
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2434207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0006MPOtherBCBS
TXK2434OtherLICENSE #
TX138007305Medicaid
TX110291103OtherFIRSTCARE INDIVIDUAL #
TX110291103OtherFIRSTCARE INDIVIDUAL #
TX00687JMedicare PIN