Provider Demographics
NPI:1851336341
Name:ELBAAGE, THAR YAHYA YASIR (MD)
Entity Type:Individual
Prefix:DR
First Name:THAR
Middle Name:YAHYA YASIR
Last Name:ELBAAGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:THAR
Other - Middle Name:
Other - Last Name:EL BAAGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4833 SARATOGA BLVD. PMB 298
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413
Mailing Address - Country:US
Mailing Address - Phone:361-452-8360
Mailing Address - Fax:361-452-8359
Practice Address - Street 1:7101 SPID DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4913
Practice Address - Country:US
Practice Address - Phone:361-452-8360
Practice Address - Fax:361-452-8359
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA61063207R00000X
NC2015-02219207R00000X
OH35.083741207R00000X
FLME119419207R00000X
WI49634207R00000X
NY248240207R00000X, 207RC0200X
ARE-12484207R00000X
MI4301078514207R00000X
MDD67117207R00000X
VA0101245193207RC0200X
TN53503207RC0200X
SC81964207RC0200X
LA327987207RC0200X
TXQ2762207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34897500Medicaid
I03588Medicare UPIN