MEDICARE: YARI A TRAN P.A.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA04711	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	855N90	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1952477630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YARI A TRAN P.A.-C

Provider Business Mailing Address
First Line	:	4544 SOUTH LAMAR
Second Line	:	SUITE 700
City	:	AUSTIN
State	:	TX
Zip	:	78745-1500
Country	:	US
Telephone Number	:	512-834-4141
Fax Number	:	512-834-4142

Provider Business Practice Location Address
First Line	:	4544 S LAMAR BLVD
Second Line	:	SUITE 700
City	:	AUSTIN
State	:	TX
Zip	:	78745-1500
Country	:	US
Telephone Number	:	512-834-4141
Fax Number	:	512-834-4142

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	01/09/2012

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Directions to “ YARI A TRAN P.A.-C” Practice Location

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