Organization
V.L.Y NEUROPSYCH GROUP P.A.
Active
Organization
V.L.Y NEUROPSYCH GROUP P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VLADISLAV L. YEGANOV M.D. (OWNER)
(214) 824-9100
Entity
Organization
Contact information
Practice address
712 N WASHINGTON AVE, SUITE # 411, DALLAS, TX 75246-1619
(214) 824-9100
(214) 824-9101
Mailing address
712 N WASHINGTON AVE, SUITE # 411, DALLAS, TX 75246-1619
(214) 824-9100
(214) 824-9101
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166625701
—
TX
01
—
I08928
UPIN
—
Enumeration date
11/19/2010
Last updated
12/02/2010
Update your record
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