Basic Information
| Provider Information | |||||||||
| NPI: | 1801883665 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YANCY | ||||||||
| FirstName: | VERNA | ||||||||
| MiddleName: | JOVITA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3945 | ||||||||
| Address2: | DEPT 453 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 772533945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813588114 | ||||||||
| FaxNumber: | 2813580609 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 N TEXAS AVE | ||||||||
| Address2: | |||||||||
| City: | WEBSTER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775984925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813351700 | ||||||||
| FaxNumber: | 2813351708 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2005 | ||||||||
| LastUpdateDate: | 04/21/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | J9453 | TX | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | J9453 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8J3892 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | BY4584125 | 01 | DEA | OTHER | 8S5682 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | P00293689 | 01 | TX | RR MCR | OTHER | 133704009 | 05 | TX | MEDICAID | 133704010 | 05 | TX | MEDICAID | E0093865 | 01 | DPS | OTHER |