Provider Demographics
NPI:1851084461
Name:YINGLING CONSULATION LLC
Entity Type:Organization
Organization Name:YINGLING CONSULATION LLC
Other - Org Name:YEP CLINIC AND LASTING IMPRESSIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:YINGLING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:812-671-1824
Mailing Address - Street 1:20212 CHAMPION FOREST DRIVE
Mailing Address - Street 2:SUITE 700 PMB 170
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379
Mailing Address - Country:US
Mailing Address - Phone:812-671-1824
Mailing Address - Fax:
Practice Address - Street 1:8687 LOUETTA RD STE 275
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6677
Practice Address - Country:US
Practice Address - Phone:812-671-1824
Practice Address - Fax:830-323-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty