Provider Demographics
NPI:1821028721
Name:LEMESHEV, YAN HILLEL (MD)
Entity Type:Individual
Prefix:
First Name:YAN
Middle Name:HILLEL
Last Name:LEMESHEV
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 1:1355 RIVER BEND DRIVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247
Mailing Address - Country:US
Mailing Address - Phone:214-237-1715
Mailing Address - Fax:214-237-1743
Practice Address - Street 1:7501 LAKEVIEW PKWY
Practice Address - Street 2:STE 160
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-9322
Practice Address - Country:US
Practice Address - Phone:972-526-0340
Practice Address - Fax:972-996-1857
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0792207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BQ852OtherBLUE CROSS BLUE SHIELD
TXP00753470OtherRAILROAD MEDICARE
TX182001103Medicaid
TXP00717586OtherRAILROAD MEDICARE
TX182001102Medicaid
TX8BX670OtherBLUE CROSS BLUE SHIELD
TX8BQ852OtherBLUE CROSS BLUE SHIELD
TX8L11612Medicare PIN