Healthcare Provider Details

I. General information

NPI: 1104575018
Provider Name (Legal Business Name): CHAK LAM YEUNG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2022
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 N IH 35 E
WAXAHACHIE TX
75165-5266
US

IV. Provider business mailing address

2460 N IH 35 E
WAXAHACHIE TX
75165-5266
US

V. Phone/Fax

Practice location:
  • Phone: 469-800-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberV3982
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: