Provider Demographics
NPI:1356569230
Name:DAVID E. YARDLEY, MD, PA
Entity type:Organization
Organization Name:DAVID E. YARDLEY, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:YARDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-423-1500
Mailing Address - Street 1:1821 SESAME DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-9288
Mailing Address - Country:US
Mailing Address - Phone:956-423-1500
Mailing Address - Fax:956-423-3155
Practice Address - Street 1:1821 S SESAME SQ
Practice Address - Street 2:SUITE 5
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-9288
Practice Address - Country:US
Practice Address - Phone:956-423-1500
Practice Address - Fax:956-423-3155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00855VOtherBLUE CROSS BLUE SHIELD
TXDA4546OtherRAILROAD MEDICARE
TX162428001Medicaid
TX162428001Medicaid
TX00855VMedicare UPIN