Provider Demographics
NPI:1790153351
Name:YAPO, ESSIE (REEGT)
Entity Type:Individual
Prefix:
First Name:ESSIE
Middle Name:
Last Name:YAPO
Suffix:
Gender:F
Credentials:REEGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 VERMILLION OAK ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-2050
Mailing Address - Country:US
Mailing Address - Phone:888-347-9109
Mailing Address - Fax:888-347-9109
Practice Address - Street 1:2026 VERMILLION OAK ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-2050
Practice Address - Country:US
Practice Address - Phone:888-347-9109
Practice Address - Fax:888-347-9109
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5558246ZE0500X, 246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1790153351Medicaid