Provider Demographics
NPI:1851560205
Name:WON, YOUNG-SAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YOUNG-SAM
Middle Name:
Last Name:WON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 WORTH ST
Mailing Address - Street 2:SUITE 170
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2006
Mailing Address - Country:US
Mailing Address - Phone:214-370-1618
Mailing Address - Fax:214-370-1622
Practice Address - Street 1:3535 WORTH ST
Practice Address - Street 2:SUITE 170
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2006
Practice Address - Country:US
Practice Address - Phone:214-370-1618
Practice Address - Fax:214-370-1622
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX382131835X0200X
MI53020284471835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology