MEDICARE: RONICA YALAMANCHILI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YP0228X	Pediatric Otolaryngology Physician	V1305	TX
2	207Y00000X	Otolaryngology Physician	V1305	TX

General Provider Information

NPI Number	:	1124474382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONICA YALAMANCHILI M.D.

Provider Business Mailing Address
First Line	:	783 N DENTON TAP RD STE 200
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-2171
Country	:	US
Telephone Number	:	972-745-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	783 N DENTON TAP RD STE 200
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-2171
Country	:	US
Telephone Number	:	972-745-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2016
Last Update Date	:	03/31/2026

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