Provider Demographics
NPI:1538417324
Name:JEFFREY A. YONKER, OD, PLLC
Entity type:Organization
Organization Name:JEFFREY A. YONKER, OD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:YONKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-583-0861
Mailing Address - Street 1:401 W WHITESTONE BLVD BLDG B200
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7798
Mailing Address - Country:US
Mailing Address - Phone:512-583-0861
Mailing Address - Fax:
Practice Address - Street 1:401 W WHITESTONE BLVD
Practice Address - Street 2:STE. B-200
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7757
Practice Address - Country:US
Practice Address - Phone:215-522-9667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7473TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty