Active NPI
Charles F Yackulic, MD
- Psychiatry Physician
- Denton, TX
National Provider Identifier
1003909672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- L1244
- Practice address
- 914 N Locust St
Denton, TX 76201-2954 - Phone
- (940) 387-6250
- Fax
- (940) 387-6274
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | L1244 | TX | Primary |
Addresses
Primary practice location
914 N Locust St
Denton, TX 76201-2954
Mailing address
914 N Locust St
Denton, TX 76201-2954
Phone (940) 387-6250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 148742304 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pecan Valley MHMR Region | Past | Accepting new patients | |
| Milestone Geriatric Day Care, Inc | Past | Accepting new patients | |
| Daniel Lennard Creson PA | Psychiatry | Past | Accepting new patients |
| Milestone Geriatric Day Care, Inc | Past | Accepting new patients | |
| Pecan Valley MHMR Region | Psychiatry | Past | Accepting new patients |
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatry Physician
- Denton, TX
- NPI 1427366152
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fort Worth, TX
- NPI 1063447001
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fort Worth, TX
- NPI 1184671752
-
- Primary Care Nurse Practitioner
- Cleburne, TX
- NPI 1285342295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258934400000",
"number": "1003909672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 N LOCUST ST",
"city": "DENTON",
"state": "TX",
"postal_code": "762012954",
"telephone_number": "940-387-6250",
"fax_number": "940-387-6274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 N LOCUST ST",
"city": "DENTON",
"state": "TX",
"postal_code": "762012954",
"telephone_number": "940-387-6250",
"fax_number": "940-387-6274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YACKULIC",
"first_name": "CHARLES",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2009-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "L1244",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "148742304",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.