Active NPI
Yula Alexandria Indeyeva, M.D.
- Otolaryngology/Facial Plastic Surgery Physician
- Austin, TX
National Provider Identifier
1780945378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology/Facial Plastic Surgery Physician
- License
- S3401
- Practice address
- 5100 W Highway 290 Ste 140
Austin, TX 78735-9000 - Phone
- (512) 831-5397
- Fax
- (512) 669-5603
- NPI assigned
- May 31, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | S3401 | TX | Primary |
Addresses
Primary practice location
5100 W Highway 290 Ste 140
Austin, TX 78735-9000
Mailing address
5100 W Highway 290 Ste 140
Austin, TX 78735-9000
Phone (512) 831-5397
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S3401 | TX | MD | Otolaryngology/Facial Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Citizens Medical Center County of Victoria | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Victoria, TX
- NPI 1124052162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1780945378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 W HIGHWAY 290 STE 140",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787359000",
"telephone_number": "512-831-5397",
"fax_number": "512-669-5603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 W HIGHWAY 290 STE 140",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787359000",
"telephone_number": "512-831-5397",
"fax_number": "512-669-5603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INDEYEVA",
"first_name": "YULA",
"middle_name": "ALEXANDRIA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-31",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0905X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": "TX",
"license": "S3401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.