MEDICARE: DR. MARIANA BRAGA YAGER M.D.

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	207RN0300X	Nephrology Physician	P4131	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801100342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIANA BRAGA YAGER M.D.

Provider Business Mailing Address
First Line	:	1420 VICEROY DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-2208
Country	:	US
Telephone Number	:	214-358-2300
Fax Number	:	214-579-6966

Provider Business Practice Location Address
First Line	:	1250 8TH AVE STE 500
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76104-4145
Country	:	US
Telephone Number	:	214-358-2300
Fax Number	:

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

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	02/27/2018

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