Individual provider Active NPI

Charles Joseph Yourshaw III, D.O.

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1932491552
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
Q8397 Issued in TX
Practice address
4055 Valley View LN Ste 700
Dallas, TX 75244-5045
Phone
(877) 868-5351
NPI assigned
May 16, 2011
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Q8397 TX Primary

Addresses

Primary practice location

4055 Valley View LN Ste 700
Dallas, TX 75244-5045

Mailing address

941 Southgate LN
Prosper, TX 75078-2249
Phone (570) 449-7517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WI, NY3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190724003854 TX Practitioner - General Practice 2062748304 Reassigns benefits to 2 organizations
I20230627003085 WI Practitioner - Osteopathic Manipulative Medicine 2062748304 Reassigns benefits to 1 organization
I20240209002411 NY Practitioner - General Practice 2062748304 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Jul 12, 2019 Accepting new patients
Vpa of Texas PLLC General Practice CurrentSince Jul 12, 2019 Accepting new patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Jul 12, 2019 Accepting new patients
Brookview Medical Associates, PLLC General Practice CurrentSince Dec 30, 2023 Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1932491552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 SOUTHGATE LN",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782249",
            "telephone_number": "570-449-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445045",
            "telephone_number": "877-868-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOURSHAW",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-16",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "Q8397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.