MEDICARE: KEVIN DANIEL YEH DDS

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	122300000X	Dentist	20672	TX

General Provider Information

NPI Number	:	1609968411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN DANIEL YEH DDS

Provider Business Mailing Address
First Line	:	4503A WOODHEAD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4411
Country	:	US
Telephone Number	:	832-265-3865
Fax Number	:	713-422-2457

Provider Business Practice Location Address
First Line	:	3800 N SHEPHERD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-6400
Country	:	US
Telephone Number	:	713-802-0011
Fax Number	:	713-422-2457

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	02/22/2013

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