Provider Demographics
NPI:1952501561
Name:FONG, YOLANDA ERIKA (MD)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:ERIKA
Last Name:FONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5327 N CENTRAL EXPY STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-3380
Mailing Address - Country:US
Mailing Address - Phone:214-219-5880
Mailing Address - Fax:214-219-5881
Practice Address - Street 1:5327 N CENTRAL EXPY STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-3380
Practice Address - Country:US
Practice Address - Phone:214-219-5880
Practice Address - Fax:214-219-5881
Is Sole Proprietor?:No
Enumeration Date:2007-07-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5164207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology