Provider Demographics
NPI: | 1992101125 |
---|---|
Name: | YANG, KUO-CHUN (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | KUO-CHUN |
Middle Name: | |
Last Name: | YANG |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | DR |
Other - First Name: | KUO |
Other - Middle Name: | CHUN |
Other - Last Name: | YANG |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | MD |
Mailing Address - Street 1: | 4516 BURLESON RD UNIT 18273 |
Mailing Address - Street 2: | |
Mailing Address - City: | AUSTIN |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78744-1204 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 512-212-7565 |
Mailing Address - Fax: | 888-719-7648 |
Practice Address - Street 1: | 1806 MONTOPOLIS DR |
Practice Address - Street 2: | |
Practice Address - City: | AUSTIN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78741-5132 |
Practice Address - Country: | US |
Practice Address - Phone: | 512-212-7565 |
Practice Address - Fax: | 888-719-7648 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2014-11-17 |
Last Update Date: | 2023-05-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 6420803 | 101YM0800X |
MN | 243328 | 103K00000X, 111NN0400X, 2084H0002X, 2084P2900X |
TX | POST-DOCTORAL FELLOW | 103TA0400X |
VA | 500297279 | 1041C0700X |
DC | A649065 | 146D00000X, 146N00000X |
KS | 9156199 | 207Q00000X |
IL | 00188147 | 207SG0201X, 207QH0002X |
DC | 000557546I | 207VH0002X |
FL | 25373342 | 2083P0901X |
390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207QH0002X | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No | 111NN0400X | Chiropractic Providers | Chiropractor | Neurology |
No | 146D00000X | Emergency Medical Service Providers | Personal Emergency Response Attendant | |
No | 146N00000X | Emergency Medical Service Providers | Emergency Medical Technician, Basic | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
No | 207SG0201X | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) |
No | 207VH0002X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Hospice and Palliative Medicine |
No | 2083P0901X | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine |
No | 2084H0002X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Hospice and Palliative Medicine |
No | 2084P2900X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Pain Medicine |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |