MEDICARE: ZAINETH MARIA YANCEY MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	R0772	TX

General Provider Information

NPI Number	:	1295113835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAINETH MARIA YANCEY MD

Provider Business Mailing Address
First Line	:	6815 HARRISBURG BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-4625
Country	:	US
Telephone Number	:	713-715-4460
Fax Number	:

Provider Business Practice Location Address
First Line	:	6812 HARRISBURG BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-4626
Country	:	US
Telephone Number	:	713-715-4460
Fax Number	:	713-715-4465

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

Provider Enumeration Date	:	05/15/2015
Last Update Date	:	11/16/2020

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