Provider Demographics
NPI:1689040941
Name:MCDONALD, YVONNE
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 MARVIN D LOVE FWY
Mailing Address - Street 2:326
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3185
Mailing Address - Country:US
Mailing Address - Phone:817-714-9879
Mailing Address - Fax:
Practice Address - Street 1:7310 MARVIN D LOVE FWY
Practice Address - Street 2:326
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3185
Practice Address - Country:US
Practice Address - Phone:817-714-9879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0801245652343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)