Provider Demographics
NPI:1225152341
Name:YOST, JASON ALAN (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ALAN
Last Name:YOST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MALL DR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2560
Mailing Address - Country:US
Mailing Address - Phone:903-336-3412
Mailing Address - Fax:903-949-6039
Practice Address - Street 1:2001 MALL DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2560
Practice Address - Country:US
Practice Address - Phone:903-306-2126
Practice Address - Fax:903-949-6039
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5293207Q00000X
TXN5500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine