Healthcare Provider Details

I. General information

NPI: 1902123698
Provider Name (Legal Business Name): TERRY YEUNG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5012 S US HIGHWAY 75 SUITE 230
DENISON TX
75020-4634
US

IV. Provider business mailing address

5012 S US HIGHWAY 75 STE 300 ATTN. BILLING
DENISON TX
75020-4589
US

V. Phone/Fax

Practice location:
  • Phone: 903-416-6090
  • Fax: 903-416-6091
Mailing address:
  • Phone: 903-416-6090
  • Fax: 903-416-6091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number8838
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberQ9096
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberQ9096
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberQ9096
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: