Provider Demographics
NPI:1417846627
Name:BELL, YUSHAWN
Entity type:Individual
Prefix:
First Name:YUSHAWN
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CAPROCK DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-2280
Mailing Address - Country:US
Mailing Address - Phone:817-204-7172
Mailing Address - Fax:
Practice Address - Street 1:110 CAPROCK DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-2280
Practice Address - Country:US
Practice Address - Phone:817-204-7172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224P00000X, 332BC3200X, 332B00000X
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment