Provider Demographics
NPI:1245780402
Name:PHILIP H. YEILDING P.C.
Entity Type:Organization
Organization Name:PHILIP H. YEILDING P.C.
Other - Org Name:MOSAIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:H
Authorized Official - Last Name:YEILDING
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:903-815-4007
Mailing Address - Street 1:600 N HIGHLAND AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-5631
Mailing Address - Country:US
Mailing Address - Phone:903-328-6234
Mailing Address - Fax:903-207-1023
Practice Address - Street 1:600 N HIGHLAND AVE STE 108
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-5631
Practice Address - Country:US
Practice Address - Phone:903-328-6234
Practice Address - Fax:903-207-1023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00748207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX385081ZLQVMedicare UPIN
S11773Medicare UPIN