Provider Demographics
NPI:1629014915
Name:YURVATI, ALBERT H (DO)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:H
Last Name:YURVATI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:ALBERT
Other - Middle Name:H
Other - Last Name:YURVATI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 99335
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0335
Mailing Address - Country:US
Mailing Address - Phone:817-735-5450
Mailing Address - Fax:817-735-5454
Practice Address - Street 1:855 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2553
Practice Address - Country:US
Practice Address - Phone:817-735-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2655208G00000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043963001Medicaid
TX330005404OtherRAILROAD MEDICARE PIN
TX84034XOtherBCBS
TX043963002Medicaid
TXF83552Medicare UPIN
TX85635NMedicare PIN