MEDICARE: KIMBERLY G. YEN M.D.

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	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	L5189	TX
2	207W00000X	Ophthalmology Physician	L5189	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
2	8G7721	OTHER	TX	BC/BS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4201492	OTHER	TX	BLUE LINK
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487643847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY G. YEN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 4771
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77210-4771
Country	:	US
Telephone Number	:	832-822-3230
Fax Number	:	713-796-8110

Provider Business Practice Location Address
First Line	:	6701 FANNIN ST
Second Line	:	SUITE 510.00
City	:	HOUSTON
State	:	TX
Zip	:	77030-2316
Country	:	US
Telephone Number	:	832-822-3230
Fax Number	:	832-825-4776

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	08/05/2024

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Directions to “ KIMBERLY G. YEN M.D.” Practice Location

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