Provider Demographics
NPI:1689899221
Name:YOON, VIVIENNE (MD)
Entity Type:Individual
Prefix:
First Name:VIVIENNE
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5236 W UNIVERSITY DR
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7889
Mailing Address - Country:US
Mailing Address - Phone:469-800-5400
Mailing Address - Fax:469-800-5410
Practice Address - Street 1:5236 W UNIVERSITY DR
Practice Address - Street 2:SUITE 2200
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7889
Practice Address - Country:US
Practice Address - Phone:469-800-5400
Practice Address - Fax:469-800-5410
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10035559207RE0101X
TXN9495207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX305622801Medicaid
TXTXB162930Medicare PIN