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NPI 1063923217

NPI 1063923217 : YARBROUGH RSVZ PLLC : EL PASO, TX

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General NPI Number Information
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    NPI Number           |    1063923217
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    Entity Type          |    Organization 
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    Legal Business Name  |    YARBROUGH RSVZ PLLC 
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Dates
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    Enumeration Date     |    10/16/2017
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    Last Update Date     |    10/16/2017
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Provider Practice Location Address
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    Address Line         |    2200 N YARBROUGH DR STE 3 
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    City                 |    EL PASO
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    State                |    TX
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    Zip                  |    79925-6337
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    Country              |    US
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    Telephone            |    214-493-1216
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    Fax                  |    214-292-8661
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Provider Business Mailing Address
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    Address Line         |    519 N CEDAR RIDGE DR STE 101 
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    City                 |    DUNCANVILLE
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    State                |    TX
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    Zip                  |    75116-3183
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    Country              |    US
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    Telephone            |    214-493-1216
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    Fax                  |    214-292-8661
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Authorized Official
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    Title or Position    |    MANAGER
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    Name                 |     NINA  ABTAHI 
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    Credential           |    
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    Telephone            |    214-493-1216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    31045
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    License Number State |    TX
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