Provider Demographics
NPI:1417157561
Name:YEAMANS, GABRIEL MARK (MD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:MARK
Last Name:YEAMANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 ACROPOLIS WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8909
Mailing Address - Country:US
Mailing Address - Phone:214-882-7454
Mailing Address - Fax:888-763-1157
Practice Address - Street 1:800 W CAMPBELL RD # SSB4.600
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3021
Practice Address - Country:US
Practice Address - Phone:972-439-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN82582084P0800X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry