Provider Demographics
NPI:1407265853
Name:YANEZ, MARCO (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:
Last Name:YANEZ
Suffix:
Gender:M
Credentials:APRN, FNP-BC
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 3238
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-0055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:833 W DOVE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3508
Practice Address - Country:US
Practice Address - Phone:956-618-3979
Practice Address - Fax:956-618-3975
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX375007701Medicaid
TX591255YVDAOtherMEDICARE
TX8HP691OtherBCBS OF TEXAS