Provider Demographics
NPI:1154584449
Name:YATES, MARIANA MARIN (MD)
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:MARIN
Last Name:YATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIANA
Other - Middle Name:ESTHER
Other - Last Name:MARIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:529 LINDBERGH AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-2529
Mailing Address - Country:US
Mailing Address - Phone:703-409-9253
Mailing Address - Fax:915-566-8120
Practice Address - Street 1:128 THUNDERBIRD DR STE E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4570
Practice Address - Country:US
Practice Address - Phone:915-566-9369
Practice Address - Fax:915-566-8120
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.207546207RE0101X
TXP1356207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism