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Individual

JEAN RENE YATES-HALBERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.A.-C.

Contact information

Practice address
209 W MAIN STREET, SUITE D, HALLSVILLE, TX 75650
(903) 668-7462
(903) 668-7400
Mailing address
PO BOX 873, HALLSVILLE, TX 75650-0873

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00602
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
334524102
TX
05
334524103
TX
05
334524105
TX
01
75-0818167-015
TRICARE
TX
01
75-0818167-022
TRICARE
TX
01
75-0818167-048
TRICARE
TX
01
75-2616977-002
TRICARE
TX
01
75-2616977-007
TRICARE
TX
01
75-2616977-028
TRICARE
TX
01
751976930005
TRICARE
TX
01
8071NR
BCBS
TX
01
8590NP
BCBS
TX
01
8983NM
BCBS
TX
01
8987NU
BCBS
TX
01
P01434527
RAIL ROAD MEDICARE
TX
01
P01479468
RAIL ROAD MEDICARE
TX
01
P01635747
RAIL ROAD MEDICARE
TX
Enumeration date
07/08/2005
Last updated
02/15/2022
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