Healthcare Provider Details

I. General information

NPI: 1912327818
Provider Name (Legal Business Name): BENJAMIN TINLUP YEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2014
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 EAST RD RM 3236
HOUSTON TX
77054
US

IV. Provider business mailing address

301 UNIVERSITY BLVD
GALVESTON TX
77555-1206
US

V. Phone/Fax

Practice location:
  • Phone: 713-486-2571
  • Fax:
Mailing address:
  • Phone: 409-747-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR6715
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: