Provider Demographics
NPI:1487778106
Name:KOH, YOUNGSEOK (DC)
Entity type:Individual
Prefix:DR
First Name:YOUNGSEOK
Middle Name:
Last Name:KOH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:KOH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2035 ROYAL LN STE 280
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-3268
Mailing Address - Country:US
Mailing Address - Phone:214-352-6677
Mailing Address - Fax:214-352-6110
Practice Address - Street 1:2035 ROYAL LN. STE. 280
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-3268
Practice Address - Country:US
Practice Address - Phone:214-352-6677
Practice Address - Fax:214-352-6110
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU82779Medicare UPIN