Basic Information
| Provider Information | |||||||||
| NPI: | 1538404652 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YELLOW HOUSE CANYON EMERGENCY PHYSICIANS, PLLC | ||||||||
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| Address1: | PO BOX 98731 | ||||||||
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| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891938731 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2412 50TH ST | ||||||||
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| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794122504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9732511132 | ||||||||
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| ProviderEnumerationDate: | 11/29/2012 | ||||||||
| LastUpdateDate: | 12/05/2019 | ||||||||
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| AuthorizedOfficialLastName: | KONDAS | ||||||||
| AuthorizedOfficialFirstName: | KATHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 9732511132 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.