MEDICARE: ANGELITO F YANGO MD

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	207RN0300X	Nephrology Physician	N4859	TX

General Provider Information

NPI Number	:	1982651998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELITO F YANGO MD

Provider Business Mailing Address
First Line	:	1420 VICEROY DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-2208
Country	:	US
Telephone Number	:	214-358-2300
Fax Number	:	214-366-6127

Provider Business Practice Location Address
First Line	:	1250 8TH AVE
Second Line	:	SUITE 500
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4124
Country	:	US
Telephone Number	:	214-358-2300
Fax Number	:	214-366-6127

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	12/03/2009

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