Basic Information
| Provider Information | |||||||||
| NPI: | 1104147982 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YAFT | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2001 MACARTHUR BLVD | ||||||||
| Address2: | SUITE 520 | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729908485 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2001 MACARTHUR BLVD | ||||||||
| Address2: | SUITE 520 | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725798485 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2010 | ||||||||
| LastUpdateDate: | 08/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | P6115 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | P6115 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 3228033-03 | 05 | TX | MEDICAID |