Individual
YASHWANTH JASTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2727 BOLTON BOONE DR STE 109, DESOTO, TX 75115-2019
(972) 283-2370
(972) 296-0311
Mailing address
2727 BOLTON BOONE DR STE 109, DESOTO, TX 75115-2019
(972) 283-2370
(972) 296-0311
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.098400
OH
207R00000X
Internal Medicine Physician
Q2143
TX
207RI0200X
Infectious Disease Physician
01076185A
IN
207RI0200X
Infectious Disease Physician
207404
LA
207RI0200X
Infectious Disease Physician
Primary
Q2143
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060431
—
OH
01
—
H070410
MEDICARE PTAN
OH
Enumeration date
02/14/2011
Last updated
03/12/2020
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