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General NPI Number Information
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NPI Number | 1831104421
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Entity Type | Organization
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Legal Business Name | BENJAMIN YBARRA, P.A.
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 1600 N HIGHWAY 287 SUITE 102
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City | MANSFIELD
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State | TX
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Zip | 76063-8853
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Country | US
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Telephone | 817-453-5001
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Fax | 817-453-2521
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Provider Business Mailing Address
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Address Line | 1810 SHILOH RD SUITE 701
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City | TYLER
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State | TX
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Zip | 75703-2419
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Country | US
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Telephone | 903-581-9629
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Fax | 903-581-7597
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Authorized Official
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Title or Position | PRESIDENT
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Name | BENJAMIN YBARRA
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Credential | DO
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Telephone | 817-453-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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