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General NPI Number Information
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NPI Number | 1871704577
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Entity Type | Individual
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Provider Name | YUSUKE YAHAGI M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 120 HILLCREST MEDICAL BLVD
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City | WACO
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State | TX
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Zip | 76712-8948
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Country | US
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Telephone | 254-202-4000
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Fax | 361-573-0633
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Provider Business Mailing Address
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Address Line | PO BOX 844658
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City | DALLAS
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State | TX
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Zip | 75284-4658
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Country | US
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Telephone | 254-724-2111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | M2210
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License Number State | TX
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