Provider Demographics
NPI:1598319105
Name:YEARWOOD, EILEEN HOYLE (PNP)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:HOYLE
Last Name:YEARWOOD
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 VICTORY GROUP WAY STE 305
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6722
Mailing Address - Country:US
Mailing Address - Phone:972-324-3480
Mailing Address - Fax:
Practice Address - Street 1:3535 VICTORY GROUP WAY STE 305
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6722
Practice Address - Country:US
Practice Address - Phone:469-333-1543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142327363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty