Provider Demographics
NPI:1871082065
Name:KO, YO HAN (LAC, LMT)
Entity type:Individual
Prefix:MR
First Name:YO
Middle Name:HAN
Last Name:KO
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 LBJ FWY STE 185
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6565
Mailing Address - Country:US
Mailing Address - Phone:214-691-3210
Mailing Address - Fax:
Practice Address - Street 1:6200 LBJ FWY STE 185
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6565
Practice Address - Country:US
Practice Address - Phone:214-691-3210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01533171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist