Provider Demographics
NPI:1265750160
Name:MY HEALTH CLINIC PLLC
Entity type:Organization
Organization Name:MY HEALTH CLINIC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEESEOK
Authorized Official - Middle Name:
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-846-3782
Mailing Address - Street 1:1400 BLALOCK RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-4483
Mailing Address - Country:US
Mailing Address - Phone:281-846-3782
Mailing Address - Fax:713-984-8858
Practice Address - Street 1:1400 BLALOCK RD
Practice Address - Street 2:SUITE I
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4483
Practice Address - Country:US
Practice Address - Phone:281-846-3782
Practice Address - Fax:713-984-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB117866Medicare PIN
TX270176Medicare PIN