MEDICARE: MARIEL ELOISA YUMUL FNP

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	363LP2300X	Primary Care Nurse Practitioner	1191094	TX

General Provider Information

NPI Number	:	1780555201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIEL ELOISA YUMUL FNP

Provider Business Mailing Address
First Line	:	2721 CENTRAL DR
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-4810
Country	:	US
Telephone Number	:	682-703-8881
Fax Number	:	706-203-3259

Provider Business Practice Location Address
First Line	:	2721 CENTRAL DR
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-4810
Country	:	US
Telephone Number	:	682-703-8881
Fax Number	:	706-203-3259

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

Provider Enumeration Date	:	09/16/2025
Last Update Date	:	05/24/2026

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