Provider Demographics
NPI:1588379952
Name:JOSEPH L YEARGAIN DPM PLLC
Entity type:Organization
Organization Name:JOSEPH L YEARGAIN DPM PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:STILLWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-851-0144
Mailing Address - Street 1:3801 GASTON AVE
Mailing Address - Street 2:STE 330
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1541
Mailing Address - Country:US
Mailing Address - Phone:214-824-3851
Mailing Address - Fax:214-824-3852
Practice Address - Street 1:1411 NORTH BECKLEY AVE
Practice Address - Street 2:STE 456
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1201
Practice Address - Country:US
Practice Address - Phone:214-824-3851
Practice Address - Fax:214-824-3852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty