MEDICARE: DR. CHRISTY YEET-YEON JEW O.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	152W00000X	Optometrist	7600TG	TX

General Provider Information

NPI Number	:	1710290655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTY YEET-YEON JEW O.D.

Provider Business Mailing Address
First Line	:	6519 FM 1488 RD
Second Line	:	SUITE 503
City	:	MAGNOLIA
State	:	TX
Zip	:	77354-3263
Country	:	US
Telephone Number	:	281-946-2020
Fax Number	:	281-946-2025

Provider Business Practice Location Address
First Line	:	6519 FM 1488 RD
Second Line	:	SUITE 503
City	:	MAGNOLIA
State	:	TX
Zip	:	77354-3263
Country	:	US
Telephone Number	:	281-946-2020
Fax Number	:	281-946-2025

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

Provider Enumeration Date	:	07/20/2010
Last Update Date	:	11/04/2011

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