Healthcare Provider Details

I. General information

NPI: 1427494418
Provider Name (Legal Business Name): KEVIN YAVORCIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2013
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 GASTON AVE EMERGENCY DEPARTMENT
DALLAS TX
75246-2017
US

IV. Provider business mailing address

3500 GASTON AVE EMERGENCY DEPARTMENT
DALLAS TX
75246-2017
US

V. Phone/Fax

Practice location:
  • Phone: 214-820-0111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberQ7815
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: