Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 21450 | TX |
N | 1223P0221X | Pediatric Dentist | DE00011056 | WA |
NPI | 1093907602 |
---|---|
Provider Name | Dr. Gloria Yanez |
First Address | Austin, TX 78754-2154 |
Second Address | Austin, TX 78754-2154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2007 |
Last Update Date | 02/07/2015 |