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NPI Code Detail

MEDICARE: BRANDON YATES

MEDICARE: BRANDON YATES
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
1225200000XPhysical Therapy Assistant2079283TX

General Provider Information

NPI Number : 1568941136
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON YATES
Provider Business Mailing Address
First Line : 9612 WOODVALE DR
Second Line :
City : AUSTIN
State : TX
Zip : 78729-3563
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1373 N AVENUE C
Second Line :
City : ELGIN
State : TX
Zip : 78621-1528
Country : US
Telephone Number : 512-285-2459
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2018
Last Update Date : 08/14/2018

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Directions to “ BRANDON YATES ” Practice Location

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