MEDICARE: DR. JAE HONG YOO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	F0358	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225008311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAE HONG YOO MD

Provider Business Mailing Address
First Line	:	3445 EXECUTIVE CENTER DR
Second Line	:	SUITE 250
City	:	AUSTIN
State	:	TX
Zip	:	78731-1678
Country	:	US
Telephone Number	:	512-579-4000
Fax Number	:	512-439-2814

Provider Business Practice Location Address
First Line	:	3445 EXECUTIVE CENTER DR
Second Line	:	SUITE 250
City	:	AUSTIN
State	:	TX
Zip	:	78731-1678
Country	:	US
Telephone Number	:	512-579-4000
Fax Number	:	512-439-2814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	04/16/2012

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Directions to “ DR. JAE HONG YOO MD” Practice Location

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