Provider Demographics
NPI:1992719298
Name:YEILDING, PHILIP HOWARD (PA)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:HOWARD
Last Name:YEILDING
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3701 N LOY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2501
Mailing Address - Country:US
Mailing Address - Phone:903-815-4007
Mailing Address - Fax:
Practice Address - Street 1:1810 W US HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7069
Practice Address - Country:US
Practice Address - Phone:903-815-4007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00748363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S11773Medicare UPIN