Healthcare Provider Details
I. General information
NPI: 1235513243
Provider Name (Legal Business Name): JOSEPH L YEARGAIN DPM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/20/2015
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3801 GASTON AVE SUITE 330
DALLAS TX
75246-1541
US
IV. Provider business mailing address
3801 GASTON AVE SUITE 330
DALLAS TX
75246-1541
US
V. Phone/Fax
- Phone: 214-824-3851
- Fax: 214-824-3852
- Phone: 214-824-3851
- Fax: 214-824-3852
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
LEE
YEARGAIN
Title or Position: OWNER
Credential: DPM
Phone: 214-824-3852