Provider Demographics
NPI:1306225925
Name:YANAYEVA, YEVGENIYA (DC)
Entity Type:Individual
Prefix:DR
First Name:YEVGENIYA
Middle Name:
Last Name:YANAYEVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8102 SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-3829
Mailing Address - Country:US
Mailing Address - Phone:972-247-7246
Mailing Address - Fax:
Practice Address - Street 1:8102 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-3829
Practice Address - Country:US
Practice Address - Phone:972-247-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor