Provider Demographics
NPI:1679655328
Name:CHAN, YEUNG HOI (MD)
Entity Type:Individual
Prefix:DR
First Name:YEUNG
Middle Name:HOI
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N KING ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5836
Mailing Address - Country:US
Mailing Address - Phone:830-379-0305
Mailing Address - Fax:830-379-0330
Practice Address - Street 1:205 N KING ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5836
Practice Address - Country:US
Practice Address - Phone:830-379-0305
Practice Address - Fax:830-379-0330
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9150207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121432201Medicaid
TX121432201Medicaid
TX00BP56Medicare ID - Type Unspecified