1851591275 NPI number — DR. YOO EUN EMILY GULDEN MSN, DRAP, CRNA

Table of content: DR. YOO EUN EMILY GULDEN MSN, DRAP, CRNA (NPI 1851591275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851591275 NPI number — DR. YOO EUN EMILY GULDEN MSN, DRAP, CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GULDEN
Provider First Name:
YOO EUN
Provider Middle Name:
EMILY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MSN, DRAP, CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DOERING
Provider Other First Name:
YOO EUN
Provider Other Middle Name:
EMILY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1851591275
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 840853
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-0853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-233-1999
Provider Business Mailing Address Fax Number:
972-233-3666

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7777 FOREST LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-500-9133
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  AP116339 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 187578304 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8920UC . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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