Provider Demographics
NPI:1710979133
Name:HE, YONG
Entity Type:Individual
Prefix:DR
First Name:YONG
Middle Name:
Last Name:HE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 ROBBIE MINCE WAY
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2012
Mailing Address - Country:US
Mailing Address - Phone:214-622-6300
Mailing Address - Fax:214-622-6310
Practice Address - Street 1:1001 ROBBIE MINCE WAY
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2012
Practice Address - Country:US
Practice Address - Phone:214-622-6300
Practice Address - Fax:214-622-6310
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM07522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175200802Medicaid
TXI39425Medicare UPIN
TX8F6912Medicare PIN
TXP00466480Medicare PIN