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NPI Code Detail

MEDICARE: STEPHANIE KONSTANDENA YIANITSAS PA-C

MEDICARE: STEPHANIE KONSTANDENA YIANITSAS PA-C
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
1363A00000XPhysician AssistantTX

General Provider Information

NPI Number : 1215824040
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE KONSTANDENA YIANITSAS PA-C
Provider Business Mailing Address
First Line : 4441 W AIRPORT FWY STE 215
Second Line :
City : IRVING
State : TX
Zip : 75062-5959
Country : US
Telephone Number : 214-755-4920
Fax Number :
Provider Business Practice Location Address
First Line : 4441 W AIRPORT FWY STE 215
Second Line :
City : IRVING
State : TX
Zip : 75062-5959
Country : US
Telephone Number : 469-440-2667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2025
Last Update Date : 08/09/2025

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Directions to “ STEPHANIE KONSTANDENA YIANITSAS PA-C” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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