Individual
IN SOO YO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 W MEDICAL CENTER BLVD, #600, WEBSTER, TX 77598-4234
(281) 332-4596
(281) 332-9610
Mailing address
450 W MEDICAL CENTER BLVD, #600, WEBSTER, TX 77598-4234
(281) 332-4596
(281) 332-9610
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K9939
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045396102
—
TX
05
—
045396103
—
TX
01
—
7601100
AETNA
TX
01
—
8U9952
BCBS
TX
01
—
8V5438
HMO BLUE
TX
01
—
P00351137
RAILROAD MEDICARE
TX
01
—
P00772809
RAILROAD MEDICARE
TX
Enumeration date
02/21/2006
Last updated
01/28/2022
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