MEDICARE: VICTORIA YUJUNG PARK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	67687	TX

General Provider Information

NPI Number	:	1699357137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA YUJUNG PARK

Provider Business Mailing Address
First Line	:	2303 BOONVILLE RD
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77808-2232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2303 BOONVILLE RD
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77808-2232
Country	:	US
Telephone Number	:	979-774-8377
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2021
Last Update Date	:	05/25/2023

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Directions to “ VICTORIA YUJUNG PARK ” Practice Location

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