Provider Demographics
NPI:1659032985
Name:DEAR, YEDIDYA K (MSN, APRN, CRNP, RN)
Entity type:Individual
Prefix:MR
First Name:YEDIDYA
Middle Name:K
Last Name:DEAR
Suffix:
Gender:M
Credentials:MSN, APRN, CRNP, RN
Other - Prefix:
Other - First Name:DIDDY
Other - Middle Name:
Other - Last Name:DEAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 795801
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-5801
Mailing Address - Country:US
Mailing Address - Phone:469-718-9110
Mailing Address - Fax:
Practice Address - Street 1:4674 MCDERMOTT RD STE 308
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7797
Practice Address - Country:US
Practice Address - Phone:972-424-4243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-08
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1065937163W00000X, 163WC0200X, 363L00000X
TX292904183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No183700000XPharmacy Service ProvidersPharmacy Technician