Healthcare Provider Details

I. General information

NPI: 1689093593
Provider Name (Legal Business Name): YEUNG COL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2509 HEMINGWAY TRL
SCHERTZ TX
78154-1145
US

IV. Provider business mailing address

2509 HEMINGWAY TRL
SCHERTZ TX
78154-1145
US

V. Phone/Fax

Practice location:
  • Phone: 512-638-9979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SCOTT YEUNG
Title or Position: ADMINISTRATOR
Credential:
Phone: 512-638-9979