Provider Demographics
NPI:1699124966
Name:YZ HEALTHCARE PA
Entity type:Organization
Organization Name:YZ HEALTHCARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JABEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-691-9800
Mailing Address - Street 1:2412 OLD NORTH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-1548
Mailing Address - Country:US
Mailing Address - Phone:972-691-9800
Mailing Address - Fax:
Practice Address - Street 1:2412 OLD NORTH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-1548
Practice Address - Country:US
Practice Address - Phone:972-691-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2305261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX346935501Medicaid