Provider Demographics
NPI:1619360310
Name:ROH, SUE YEON (NP)
Entity Type:Individual
Prefix:MISS
First Name:SUE
Middle Name:YEON
Last Name:ROH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:3200 RED RIVER ST STE 210
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2655
Mailing Address - Country:US
Mailing Address - Phone:512-472-3161
Mailing Address - Fax:512-476-4309
Practice Address - Street 1:3200 RED RIVER ST STE 210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2655
Practice Address - Country:US
Practice Address - Phone:512-472-3161
Practice Address - Fax:512-476-4309
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP126383363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health