Provider Demographics
NPI:1831493659
Name:YAMOAH, JOANNA I (PA)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:I
Last Name:YAMOAH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4673 PRAIRIE CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4223
Mailing Address - Country:US
Mailing Address - Phone:940-765-1690
Mailing Address - Fax:
Practice Address - Street 1:1208 BENT OAKS CT
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-3300
Practice Address - Country:US
Practice Address - Phone:940-566-5437
Practice Address - Fax:940-323-0553
Is Sole Proprietor?:No
Enumeration Date:2011-01-09
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07100363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX284924201Medicaid
TX284924203Medicaid
TX284924202Medicaid
TXTXB133351Medicare PIN
TX284924201Medicaid
TXTXB133353Medicare PIN