Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | G9019 | TX |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | G9019 | TX |
NPI | 1851353791 |
---|---|
Provider Name | Dr. Paul Michael Yandell |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 24/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
807684 | BLUE SHIELD (01) | TX |
B27719 | (02) | TX |