Individual
JASON EDWARD YSASAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7411 WALLACE BLVD, AMARILLO, TX 79106-1835
(806) 351-1870
(806) 355-1284
Mailing address
PO BOX 50720, AMARILLO, TX 79159-0720
(806) 467-0459
(806) 355-1284
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L4182
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150770901
—
TX
05
—
150770903
—
TX
01
—
8G3580
BCBS
TX
Enumeration date
03/16/2006
Last updated
08/06/2013
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