Provider Demographics
NPI:1700204203
Name:HANDOKO-YANG, MAUREEN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:HANDOKO-YANG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 ONYX CIR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-7805
Mailing Address - Country:US
Mailing Address - Phone:303-776-5298
Mailing Address - Fax:
Practice Address - Street 1:4562 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4228
Practice Address - Country:US
Practice Address - Phone:303-776-5298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS62002084E0001X, 2084N0402X, 2084N0400X
273100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No273100000XHospital UnitsEpilepsy Unit
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology