Provider Demographics
NPI:1922495209
Name:YU, KRYSTINA SANG (DO)
Entity Type:Individual
Prefix:
First Name:KRYSTINA
Middle Name:SANG
Last Name:YU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KRYSTINA
Other - Middle Name:LEIGH
Other - Last Name:SANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST STE JJL 324
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-7600
Mailing Address - Fax:713-500-7619
Practice Address - Street 1:4755 ALDINE MAIL RTE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-5934
Practice Address - Country:US
Practice Address - Phone:281-985-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46298207Q00000X
390200000X
TXT0398207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program