Provider Demographics
NPI:1053546671
Name:YUKIO, UYLY (DO)
Entity type:Individual
Prefix:
First Name:UYLY
Middle Name:
Last Name:YUKIO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 INTERSTATE 35 S STE 169
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4817
Mailing Address - Country:US
Mailing Address - Phone:830-620-9429
Mailing Address - Fax:830-620-9495
Practice Address - Street 1:169 INTERSTATE 35 S STE 169
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4817
Practice Address - Country:US
Practice Address - Phone:830-620-9429
Practice Address - Fax:830-620-9495
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0678207Q00000X
PAOT013116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR0678OtherTX MEDICAL LICENSE
NVGM995YMedicare PIN
NVGM995ZMedicare PIN