Provider Demographics
NPI:1902952369
Name:YEH, PETER L (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:L
Last Name:YEH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 GRINNEL DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-1318
Mailing Address - Country:US
Mailing Address - Phone:972-698-6277
Mailing Address - Fax:
Practice Address - Street 1:2126 E BELT LINE RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-3930
Practice Address - Country:US
Practice Address - Phone:972-698-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8661111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU82925Medicare UPIN