MEDICARE: BRY ANNA YANELIZ GARATE

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	390200000X	Student in an Organized Health Care Education/Training Program		TX
2	363A00000X	Physician Assistant	PA19730	TX

General Provider Information

NPI Number	:	1528786654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRY ANNA YANELIZ GARATE

Provider Business Mailing Address
First Line	:	1201 W UNIVERSITY DR
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-2909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 W UNIVERSITY DR
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-2909
Country	:	US
Telephone Number	:	956-665-7049
Fax Number	:

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

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	04/06/2026

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