Healthcare Provider Details

I. General information

NPI: 1700204203
Provider Name (Legal Business Name): MAUREEN HANDOKO-YANG MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4562 BELLAIRE BLVD
BELLAIRE TX
77401-4228
US

IV. Provider business mailing address

1908 THOMES AVE STE 12550
CHEYENNE WY
82001-3527
US

V. Phone/Fax

Practice location:
  • Phone: 303-776-5298
  • Fax:
Mailing address:
  • Phone: 303-776-5298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberS6200
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberS6200
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code273100000X
TaxonomyEpilepsy Hospital Unit
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberS6200
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberCDR.0002771
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: