Provider Demographics
NPI:1952069908
Name:HEALTH-DISPATCH MEDICAL LLC
Entity Type:Organization
Organization Name:HEALTH-DISPATCH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN'S ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:YEILDING
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:903-815-4007
Mailing Address - Street 1:3701 N LOY LAKE RD RM 300-A
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2501
Mailing Address - Country:US
Mailing Address - Phone:903-815-4007
Mailing Address - Fax:903-347-2718
Practice Address - Street 1:3701 N LOY LAKE RD RM 300-A
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2501
Practice Address - Country:US
Practice Address - Phone:903-815-4007
Practice Address - Fax:903-347-2718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4145559Medicaid