Basic Information
| Provider Information | |||||||||
| NPI: | 1629364195 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | YOON | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5005 N PIEDRAS ST | ||||||||
| Address2: | GRADUATE MEDICAL EDUCATION | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799205001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157422521 | ||||||||
| FaxNumber: | 9157422653 | ||||||||
| Practice Location | |||||||||
| Address1: | 5005 N PIEDRAS ST | ||||||||
| Address2: | GRADUATE MEDICAL EDUCATION | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157422521 | ||||||||
| FaxNumber: | 9157422653 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2011 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | S1739 | TX | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 02004253A | IN | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.