MEDICARE: MRS. JOANNA I YAMOAH P.A.

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	363A00000X	Physician Assistant	PA07100	TX
2	363A00000X	Physician Assistant

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831493659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOANNA I YAMOAH P.A.

Provider Business Mailing Address
First Line	:	4673 PRAIRIE CROSSING DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-4223
Country	:	US
Telephone Number	:	940-765-1690
Fax Number	:

Provider Business Practice Location Address
First Line	:	1208 BENT OAKS CT
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-3300
Country	:	US
Telephone Number	:	940-566-5437
Fax Number	:	940-323-0553

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

Provider Enumeration Date	:	01/09/2011
Last Update Date	:	07/31/2024

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Directions to “ MRS. JOANNA I YAMOAH P.A.” Practice Location

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