1699836700 NPI number — MRS. BELINDA D YARBROUGH APN

Table of content: MRS. BELINDA D YARBROUGH APN (NPI 1699836700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699836700 NPI number — MRS. BELINDA D YARBROUGH APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YARBROUGH
Provider First Name:
BELINDA
Provider Middle Name:
D
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699836700
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 UNIVERSITY DR E
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
COLLEGE STATION
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77840-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-846-1100
Provider Business Mailing Address Fax Number:
979-260-9390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 MEMORIAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRYAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77802-5205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-731-4520
Provider Business Practice Location Address Fax Number:
979-731-4570
Provider Enumeration Date:
12/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  574275 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 022513802 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 74-1830 . This is a "PTAN SJHPBRYAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1497183883 . This is a "BVCAA DBA: ST. JOSEPH HEALTH POINT BRYAN FACILITY NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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