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NPI Code Detail

MEDICARE: YD GREENLIGHT

MEDICARE: YD GREENLIGHT
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
1122300000XDentist22078TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G60155-1OTHERTXCHIPS

General Provider Information

NPI Number : 1336366533
Entity Type Code : Organization
Provider Name (Legal Business Name) : YD GREENLIGHT
Provider Business Mailing Address
First Line : 7333 NORTH FWY
Second Line : SUITE 300
City : HOUSTON
State : TX
Zip : 77076-1300
Country : US
Telephone Number : 713-691-4300
Fax Number : 713-691-4461
Provider Business Practice Location Address
First Line : 7333 NORTH FWY
Second Line : SUITE 300
City : HOUSTON
State : TX
Zip : 77076-1300
Country : US
Telephone Number : 713-691-4300
Fax Number : 713-691-4461
Authorized Official
Title or Position : OFFICE MANGER
Name : MRS. BLANCA URBINA
Credential :
Telephone Number : 713-691-4300
Provider Enumeration Date : 04/19/2007
Last Update Date : 08/22/2020

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Directions to “YD GREENLIGHT ” Practice Location

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