Provider Demographics
NPI:1992062335
Name:YAGEL, CLAUDIA MARIE
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:MARIE
Last Name:YAGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5337 COUNTRY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-3146
Mailing Address - Country:US
Mailing Address - Phone:915-342-0232
Mailing Address - Fax:915-703-6382
Practice Address - Street 1:2429 MONTANNA AVE
Practice Address - Street 2:#A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903
Practice Address - Country:US
Practice Address - Phone:915-342-0232
Practice Address - Fax:915-703-6382
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114760225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149984001Medicaid
TX207164901Medicaid
TX676535Medicare PIN
TX149984001Medicaid