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Individual
DR. MARISSA RENEE YATES
Active
Individual
DR. MARISSA RENEE YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4988
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194514907
—
TX
05
—
32303734
—
NM
01
—
792938
MEDICARE
TX
01
—
8KS522
BCBS
TX
Enumeration date
08/14/2007
Last updated
09/15/2020
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