Provider Demographics
NPI:1003370404
Name:YINGLING, TERRI R (LSA)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:R
Last Name:YINGLING
Suffix:
Gender:F
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7575 DR PHILLIPS BLVD STE 155
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7220
Mailing Address - Country:US
Mailing Address - Phone:407-982-4876
Mailing Address - Fax:407-650-2754
Practice Address - Street 1:5301 ALPHA RD # 33
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4355
Practice Address - Country:US
Practice Address - Phone:407-982-4876
Practice Address - Fax:407-650-2754
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX187816246ZC0007X
TXSA00847246ZC0007X
TX246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant