Healthcare Provider Details

I. General information

NPI: 1023271202
Provider Name (Legal Business Name): JOSEPH L YEARGAIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 GASTON AVE STE 330
DALLAS TX
75246-1500
US

IV. Provider business mailing address

3801 GASTON AVE STE 330
DALLAS TX
75246-1500
US

V. Phone/Fax

Practice location:
  • Phone: 214-824-3851
  • Fax: 214-824-3852
Mailing address:
  • Phone: 214-824-3851
  • Fax: 214-824-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1958
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: