Provider Demographics
NPI:1417923111
Name:YEAGER, DAREN PATRICK (MD)
Entity type:Individual
Prefix:
First Name:DAREN
Middle Name:PATRICK
Last Name:YEAGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E LAKE ST STE 260
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-3359
Mailing Address - Country:US
Mailing Address - Phone:903-590-5700
Mailing Address - Fax:903-590-5735
Practice Address - Street 1:1100 E LAKE ST STE 260
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-3359
Practice Address - Country:US
Practice Address - Phone:903-590-5700
Practice Address - Fax:903-590-5735
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5750207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FL322OtherBCBS
TX145176702Medicaid
TX75-2616977-136OtherTRICARE
TX8DC079OtherBCBS
TX752616977022OtherTRICARE
TX8B0521OtherBCBS
TX145176701Medicaid
TX752616977022OtherTRICARE
H42061Medicare UPIN
TXP01044629Medicare PIN
TX8B0521OtherBCBS