| Se Young Um, MD | |
| 
					1300 Main St, Richmond, TX 77469-3348  | |
| (281) 341-9696 | |
| (281) 762-6370 | 
| Full Name | Se Young Um | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics - Adolescent Medicine | 
| Location | 1300 Main St, Richmond, Texas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1699754994 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2080A0000X | Pediatrics - Adolescent Medicine | N2857 (Texas) | Primary | 
| 2080A0000X | Pediatrics - Adolescent Medicine | 165285 (New York) | Secondary | 
| Entity Name | Legacy Community Health Services Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1679524961 PECOS PAC ID: 7911969092 Enrollment ID: O20110706000516  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Se Young Um, MD 1300 Main St, Richmond, TX 77469-3348 Ph: (281) 341-9696  | Se Young Um, MD 1300 Main St, Richmond, TX 77469-3348 Ph: (281) 341-9696  | 
Melanie D Degroot, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 400 Austin St, Richmond, TX 77469 Phone: 281-342-4530 Fax: 281-341-2920  | |
Roula Sabbagh, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 22121 Fm 1093 Rd, Richmond, TX 77407 Phone: 713-442-4100  | |
Ms. Kavita Vishram Bapat, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 1300 Main St, Richmond, TX 77469 Phone: 281-341-9696 Fax: 281-633-2474  | |
Michael E Bornstein, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1300 Main St, Richmond, TX 77469 Phone: 281-341-9696 Fax: 281-341-6218  | |
Brittany S Richardson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 22121 Fm 1093 Rd, Richmond, TX 77407 Phone: 713-442-4100  | |
Syed Musarrat Hussain Kazmi,  Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9914 Corben Creek Ln, Richmond, TX 77407 Phone: 281-202-3169  | |
Mabel O Izekor,  Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13407 Peach Orchard Ln, Richmond, TX 77407 Phone: 617-304-8687  |