Provider Demographics
NPI:1174667844
Name:YBARRA, LETICIA M (MSN, APRN, BC, FNP)
Entity Type:Individual
Prefix:MS
First Name:LETICIA
Middle Name:M
Last Name:YBARRA
Suffix:
Gender:F
Credentials:MSN, APRN, BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78291-0087
Mailing Address - Country:US
Mailing Address - Phone:210-358-9174
Mailing Address - Fax:210-358-5753
Practice Address - Street 1:4503 S. ZARZAMORA, MS 52-2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-0087
Practice Address - Country:US
Practice Address - Phone:210-644-8600
Practice Address - Fax:210-644-8625
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX620520363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily