Healthcare Provider Details

I. General information

NPI: 1437498102
Provider Name (Legal Business Name): ELIZABETH ROSE YINGLING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2013
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W COLLEGE ST
GRAPEVINE TX
76051-3580
US

IV. Provider business mailing address

300 CLEAR CV
ARGYLE TX
76226-2375
US

V. Phone/Fax

Practice location:
  • Phone: 682-439-0091
  • Fax:
Mailing address:
  • Phone: 317-410-7852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1317437
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05009966A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: