Provider Demographics
NPI:1417928326
Name:YARRA, SUBBARAO (MD)
Entity Type:Individual
Prefix:
First Name:SUBBARAO
Middle Name:
Last Name:YARRA
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:PO BOX 4449
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4449
Mailing Address - Country:US
Mailing Address - Phone:956-362-8460
Mailing Address - Fax:956-362-8455
Practice Address - Street 1:1200 E SAVANNAH AVE
Practice Address - Street 2:STE 7
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1727
Practice Address - Country:US
Practice Address - Phone:956-362-8460
Practice Address - Fax:956-362-8455
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3882207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113469404Medicaid
TX113469401Medicaid
TX8523J1Medicare ID - Type Unspecified