Provider Demographics
NPI:1700279544
Name:LES YARMUSH MDPA
Entity Type:Organization
Organization Name:LES YARMUSH MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:713-592-9500
Mailing Address - Street 1:1517 SAN JACINTO ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-7623
Mailing Address - Country:US
Mailing Address - Phone:713-592-9500
Mailing Address - Fax:888-776-9171
Practice Address - Street 1:7701 W BELLFORT ST
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2104
Practice Address - Country:US
Practice Address - Phone:713-592-9500
Practice Address - Fax:888-776-9171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1671207Q00000X
TXPA06671363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty