Healthcare Provider Details

I. General information

NPI: 1417928326
Provider Name (Legal Business Name): SUBBARAO YARRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E SAVANNAH AVE STE 7
MCALLEN TX
78503-1727
US

IV. Provider business mailing address

PO BOX 4449
MCALLEN TX
78502-4449
US

V. Phone/Fax

Practice location:
  • Phone: 956-362-8460
  • Fax: 956-362-8455
Mailing address:
  • Phone: 956-362-8460
  • Fax: 956-362-8455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberK3882
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: