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Individual
THOMAS PETER YAKICH
Active
Individual
THOMAS PETER YAKICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
633892
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100781430A
—
OK
05
—
146490101
—
TX
05
—
146490104
—
TX
01
—
430067372
RAILROAD MEDICARE
TX
01
—
82241U
BLUE CROSS BLUE SHIELD
TX
01
—
8821UG
BCBS
TX
01
—
P01446790
RR
TX
Enumeration date
06/30/2006
Last updated
11/03/2015
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