Provider Demographics
NPI:1811007883
Name:YEPURI, JAY NANDALAL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:NANDALAL
Last Name:YEPURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7610 N STEMMONS FWY STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4228
Mailing Address - Country:US
Mailing Address - Phone:214-689-5960
Mailing Address - Fax:469-713-8084
Practice Address - Street 1:1600 CENTRAL DR
Practice Address - Street 2:SUITE 155
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6000
Practice Address - Country:US
Practice Address - Phone:817-267-8470
Practice Address - Fax:817-267-0396
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.118102207RG0100X
TXL9026207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196772101Medicaid
TX8F3158OtherBCBSTX
P00634668Medicare PIN
TX196772101Medicaid