Provider Demographics
NPI:1629628672
Name:YANCEY PAIN & SPINE, LLLP
Entity Type:Organization
Organization Name:YANCEY PAIN & SPINE, LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-219-6941
Mailing Address - Street 1:28803 DOBBIN HUFFSMITH RD
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-6474
Mailing Address - Country:US
Mailing Address - Phone:870-219-6941
Mailing Address - Fax:
Practice Address - Street 1:9200 PINECROFT DR STE 330
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3279
Practice Address - Country:US
Practice Address - Phone:346-351-2948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty