TIN WAI JUDY KOO (NPI# 1174782049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174782049 |
| Entity Type | Individual |
| Full Name | TIN WAI JUDY KOO |
| Credential | MD |
| Practice Address |
205 E University Ave Suite 200 Georgetown TX 78626-6814 |
| Practice Telephone | 5128689894 |
| Practice Fax Number | 5128689894 |
| Mailing Telephone | 5128689894 |
| Mailing Fax Number | 5128689894 |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2016-12-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
N1371 | TX | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
N1371 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
205 E UNIVERSITY AVE SUITE 200 |
| City | GEORGETOWN |
| State | TX |
| Zip Code | 78626-6814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962490870 | Kathleen Victoria Butler | Pediatrics | 205 E University Ave, Suite 200, Georgetown, TX 78626-6821 | 2005-10-13 |
| 1013340520 | Modesta Obiageli Onyia | Nurse Practitioner | 205 E University Ave, Suite 157, Georgetown, TX 78626-6814 | 2013-08-20 |
| 1245501170 | Christine Lynn Ellis | Nurse Practitioner | 205 E University Ave, Suite 157, Georgetown, TX 78626-6814 | 2012-01-24 |
| 1699053249 | Holly Martin | Nurse Practitioner | 205 E University Ave, Suite 157, Georgetown, TX 78626-6814 | 2011-08-01 |
| 1114237179 | Ashley Nicole Walters- Snider | Nurse Practitioner | 205 E University Ave, Suite 200, Georgetown, TX 78626-6814 | 2010-10-08 |
| 1225262710 | Betty L Clark | Psychologist | 205 E University Ave, Suite 155, Georgetown, TX 78626-6814 | 2009-05-12 |
| 1336388560 | Brian Bezorgmehr Mozaffari | Psychiatry & Neurology | 205 E University Ave, Suite 200, Georgetown, TX 78626-6814 | 2009-02-11 |
| 1568626430 | Jaclyn Richards | Pediatrics | 205 E University Ave, Suite 200, Georgetown, TX 78626-6814 | 2008-07-10 |
| 1952582587 | Lone Star Circle of Care | Clinic/Center | 205 E University Ave, Suite 200, Georgetown, TX 78626-6814 | 2007-11-26 |
| 1962683599 | Lone Star Circle of Care | Clinic/Center | 205 E University Ave, Suite 200, Georgetown, TX 78626-6814 | 2007-11-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932603230 | Danietra Mcgrue | Home Health Aide | 108 Blue Waterleaf Ln, Georgetown, TX 78626 | 2018-03-21 |
| 1588175673 | Kristin Marie Alaniz | Nurse Practitioner | 2112 Sw H K Dodgen Loop, Suite 110, Georgetown, TX 78626 | 2017-10-17 |
| 1669865275 | Stephen Harris | Counselor | 101 W Cooperative Way Ste 100, Georgetown, TX 78626 | 2015-03-07 |
| 1356739080 | Craig Crossman | Physical Therapy Assistant | 705 E 13th St, Georgetown, TX 78626 | 2015-01-05 |
| 1679977318 | Nancy Krenek | Physical Therapist | 2050 Rockride Ln., Georgetown, TX 78626 | 2014-10-09 |
| 1275956807 | Georgetown Behavioral Health Institute, LLC | Psychiatric Hospital | 3101 S. Austin Avenue, Georgetown, TX 78626 | 2014-02-03 |
| 1184056954 | Rock Springs, LLC | Psychiatric Hospital | 700 Southeast Inner Loop, Georgetown, TX 78626 | 2013-08-05 |
| 1447691936 | Brandon Michael Hoffman | Dentist | 1821 Westinghouse Road, Suite 1130, Georgetown, TX 78626 | 2013-07-11 |
| 1235422932 | Erica Marie Edgington | Nurse Anesthetist, Certified Registered | Westlake Anesthesia Group, Pa, 1004 South Rock Street, Georgetown, TX 78626 | 2011-05-27 |
| 1356570907 | Grace Salone | Optometrist | 950 W University Ave Ste 108, Georgetown, TX 78626 | 2009-07-03 |
| Find all providers in zip 78626 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538211941 | Keith Caramelli | Psychiatry & Neurology | 3101 S Austin Ave, Georgetown, TX 78626-7541 | 2007-01-17 |
| 1083683197 | Manuel S Valencia | Psychiatry & Neurology | 83 Baldpate Rd, Georgetown, MA 01833-2303 | 2006-03-14 |
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|---|---|---|---|---|
| 1861090243 | Ridgewood Psychiatry Pllc | Psychiatry & Neurology | 832 Ridgewood St, Brownsville, TX 78520 | 2020-10-16 |
| 1013525591 | El Paso Healthyminds Psychiatry, Pllc | Psychiatry & Neurology | 509 Rosinante Rd, El Paso, TX 79922-2224 | 2020-07-21 |
| 1073131686 | Nishan D. Adihetty Md, Pllc | Psychiatry & Neurology | 2219 Sawdust Rd Ste 1004, Spring, TX 77380-2580 | 2020-07-09 |
| 1063039535 | Sun Psychiatry Pllc | Psychiatry & Neurology | 12217 Sitting Bull Dr, El Paso, TX 79936-7891 | 2020-07-01 |
| 1942839113 | Fort Physicians & Professionals Pllc | Psychiatry & Neurology | 7140 Oakmont Boulevard, Fort Worth, TX 76132 | 2020-04-08 |
| 1720613532 | Ferruzzi Psychiatric Services, Pllc | Psychiatry & Neurology | 13409 Nw Military Hwy Ste 310, Shavano Park, TX 78231-1865 | 2020-03-12 |
| 1184276818 | Cesar Alejandro Soutullo Esperon | Psychiatry & Neurology | Ut Health, Department of Psychiatry, 1941 East Road, Houston, TX 77054-6010 | 2019-07-12 |
| 1881255594 | Aditya Sharma, Pllc | Psychiatry & Neurology | 4510 Medical Center Dr Ste 208, Mckinney, TX 75069-1602 | 2019-06-24 |
| 1154851590 | Stat Md Pllc | Psychiatry & Neurology | 2710 Sunset Strip Ste C, Greenville, TX 75402-3848 | 2017-06-18 |
| 1336693043 | Cognitive Psychiatry Pa | Psychiatry & Neurology | 1029 Highway 6 N, Ste 650-181, Houston, TX 77079-1043 | 2016-08-10 |
| Find all providers with the same taxonomy | ||||
| City | GEORGETOWN |
| Zip Code | 78626 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.