Provider Demographics
NPI:1932298981
Name:DAVID J. YANASE, MD PA
Entity Type:Organization
Organization Name:DAVID J. YANASE, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:YANASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-614-3355
Mailing Address - Street 1:7810 LOUIS PASTEUR DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3471
Mailing Address - Country:US
Mailing Address - Phone:210-614-3355
Mailing Address - Fax:
Practice Address - Street 1:7810 LOUIS PASTEUR DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3471
Practice Address - Country:US
Practice Address - Phone:210-614-3355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6824207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00188YMedicare ID - Type Unspecified