MEDICARE: YENLY PILA DMD

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	1223G0001X	General Practice Dentistry	40641	TX

General Provider Information

NPI Number	:	1255184404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YENLY PILA DMD

Provider Business Mailing Address
First Line	:	9730 HAZEL FERN CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-5395
Country	:	US
Telephone Number	:	305-431-9120
Fax Number	:	305-431-9120

Provider Business Practice Location Address
First Line	:	2525 SOUTHMORE AVE # 200
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77502-1451
Country	:	US
Telephone Number	:	713-434-6170
Fax Number	:

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

Provider Enumeration Date	:	04/08/2024
Last Update Date	:	07/26/2024

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Directions to “ YENLY PILA DMD” Practice Location

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