Provider Demographics
NPI:1386803336
Name:KOO, HOONMO LEE (MD)
Entity type:Individual
Prefix:DR
First Name:HOONMO
Middle Name:LEE
Last Name:KOO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2201 W HOLCOMBE BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2032
Mailing Address - Country:US
Mailing Address - Phone:713-791-1020
Mailing Address - Fax:713-791-1022
Practice Address - Street 1:2201 W HOLCOMBE BLVD STE 305
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2032
Practice Address - Country:US
Practice Address - Phone:713-791-1020
Practice Address - Fax:713-791-1022
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2019-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL8775207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX212856301Medicaid
TX8F2115OtherBCBS OF TEXAS