Healthcare Provider Details

I. General information

NPI: 1548268444
Provider Name (Legal Business Name): LINDA E YEATTS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 N INTERSTATE 35 SUITE 209
DENTON TX
76207-3432
US

IV. Provider business mailing address

4401 N INTERSTATE 35 SUITE 209
DENTON TX
76207-3432
US

V. Phone/Fax

Practice location:
  • Phone: 940-566-3700
  • Fax: 940-566-3774
Mailing address:
  • Phone: 940-566-3700
  • Fax: 940-566-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH5101
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: