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NPI Code Detail

MEDICARE: DR. YACARA TABB DPM

MEDICARE: DR. YACARA TABB DPM
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
1213E00000XPodiatristPD177RLA

Other Identifiers

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

General Provider Information

NPI Number : 1942275367
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YACARA TABB DPM
Provider Business Mailing Address
First Line : 103 SMART PL STE 2
Second Line :
City : SLIDELL
State : LA
Zip : 70458-2070
Country : US
Telephone Number : 985-463-3668
Fax Number : 985-463-3660
Provider Business Practice Location Address
First Line : 843 MILLING AVE
Second Line : PODIATRY DEPT
City : LULING
State : LA
Zip : 70070-4442
Country : US
Telephone Number : 985-463-3668
Fax Number : 985-463-3668
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 04/25/2025

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