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NPI Code Detail

MEDICARE: ADAM R YBARRA DDS

MEDICARE: ADAM R YBARRA DDS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1174455372
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM R YBARRA DDS
Provider Business Mailing Address
First Line : 715 OLD AUSTIN HWY STE 400
Second Line :
City : BASTROP
State : TX
Zip : 78602-5165
Country : US
Telephone Number : 512-212-9803
Fax Number :
Provider Business Practice Location Address
First Line : 715 OLD AUSTIN HWY STE 400
Second Line :
City : BASTROP
State : TX
Zip : 78602-5165
Country : US
Telephone Number : 151-221-2980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ ADAM R YBARRA DDS” Practice Location

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