Yashwanth Jasti Md Pa | |
611 N Macarthur Blvd Irving TX 75061-7428 | |
(214) 389-0855 | |
(214) 389-0859 |
Full Name | Yashwanth Jasti Md Pa |
---|---|
Speciality | Internal Medicine |
Location | 611 N Macarthur Blvd, Irving, Texas |
Authorized Official Name and Position | Yashwanth Jasti (OWNER) |
Authorized Official Contact | 2143890855 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Yashwanth Jasti Md Pa 611 N Macarthur Blvd Irving TX 75061-7428 Ph: (214) 389-0855 | Yashwanth Jasti Md Pa 611 N Macarthur Blvd Irving TX 75061-7428 Ph: (214) 389-0855 |
NPI Number | 1972015477 |
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Provider Enumeration Date | 10/25/2017 |
Last Update Date | 04/27/2021 |
Medicare PECOS PAC ID | 9638586225 |
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Medicare Enrollment ID | O20210326001050 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972015477 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | Q2143 (Texas) | Primary |
Provider Name | Yashwanth Jasti |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1871890616 PECOS PAC ID: 1153580915 Enrollment ID: I20150220001936 |
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