Organization
YVONNE BAUM M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YVONNE BAUM M.D. (OWNER)
(903) 596-3808
Entity
Organization
Contact information
Practice address
700 OLYMPIC PLAZA CIR, SUITE 912, TYLER, TX 75701-1951
(903) 596-3808
(903) 561-0836
Mailing address
700 OLYMPIC PLAZA CIR, SUITE 912, TYLER, TX 75701-1951
(903) 596-3808
(903) 561-0836
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J6823
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0078MG
BCBS GROUP
TX
05
—
171295201
—
TX
Enumeration date
10/11/2006
Last updated
06/24/2014
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