Provider Demographics
NPI:1902884356
Name:ILHAN YILDIZ M.D. PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:ILHAN YILDIZ M.D. PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ILHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YILDIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-296-7881
Mailing Address - Street 1:2404 YONKERS ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-1820
Mailing Address - Country:US
Mailing Address - Phone:806-296-7881
Mailing Address - Fax:806-293-2053
Practice Address - Street 1:2404 YONKERS ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-1820
Practice Address - Country:US
Practice Address - Phone:806-296-7881
Practice Address - Fax:806-293-2053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089845401Medicaid
TXF43042Medicare UPIN
TX089845401Medicaid