Provider Demographics
NPI:1285957142
Name:MEDEIROS, YANIRA D (CRNA)
Entity type:Individual
Prefix:
First Name:YANIRA
Middle Name:D
Last Name:MEDEIROS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:YANIRA
Other - Middle Name:
Other - Last Name:NAUGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRN
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-8800
Mailing Address - Fax:
Practice Address - Street 1:2401 S 31ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-0001
Practice Address - Country:US
Practice Address - Phone:254-724-2111
Practice Address - Fax:254-215-9699
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130504367500000X
TXAP119014367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered