NPIMap

Organization Active NPI

V.L.Y Neuropsych Group P.a.

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1720380009
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
V.L.Y NEUROPSYCH GROUP P.A.
Practice address
712 N Washington Ave
Suite # 411
Dallas, TX 75246-1619
Phone
(214) 824-9100
Fax
(214) 824-9101
NPI assigned
Nov 19, 2010
Last updated
Dec 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Vladislav L. Yeganov, M.D.NPI 1538145792
Title
Owner
Phone
(214) 824-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

712 N Washington Ave
Suite # 411
Dallas, TX 75246-1619

Mailing address

712 N Washington Ave
Suite # 411
Dallas, TX 75246-1619
Phone (214) 824-9100

Other identifiers 2

IdentifierTypeStateIssuer
166625701MedicaidTX
I08928OtherUPIN

National Provider Directory

National Provider Directory

Locations

712 N Washington Ave
Ste 411
Dallas, TX 75246
Phone (214) 515-0112

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1720380009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N WASHINGTON AVE",
            "address_2": "SUITE # 411",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461619",
            "telephone_number": "214-824-9100",
            "fax_number": "214-824-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N WASHINGTON AVE",
            "address_2": "SUITE # 411",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461619",
            "telephone_number": "214-824-9100",
            "fax_number": "214-824-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V.L.Y NEUROPSYCH GROUP P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "YEGANOV",
        "authorized_official_first_name": "VLADISLAV",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-824-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166625701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "I08928",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.