Provider Demographics
NPI:1114054228
Name:JC YABRAIAN, M.D., P.A.
Entity Type:Organization
Organization Name:JC YABRAIAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:YABRAIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-902-1440
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-0580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5920 FOREST PARK RD
Practice Address - Street 2:SUITE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6411
Practice Address - Country:US
Practice Address - Phone:214-902-1440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7372207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB27707Medicare UPIN
TX00L438Medicare PIN