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Jessica Congjun Yao

Family Medicine

Allopathic & Osteopathic Physicians

903 W Martin St, San Antonio, TX 78207-0903

PECOS Enrollment

This provider is enrolled in PECOS as JESSICA YAO.

Based on the most recent information from CMS, provider Jessica Congjun Yao is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1952538100
Provider Type
Individual
Full Name
Yao, Jessica Congjun
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
6/15/2009
Last Updated
9/22/2021

Contact Information

Practice Location

903 W Martin St, San Antonio, TX 78207-0903

(210) 358-3441

(210) 358-5944

Mailing Location

PO Box 734812, Dallas, TX 75373-4812

(210) 358-9500

(210) 358-9183

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License P4133 Texas
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License P4133 Texas

Provider Identifiers

ID	Description	Issuer
ID 349080YMKM	Description Other	Issuer MEDICARE Texas

Jessica Congjun Yao

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Trevino, Victor Jesus

Olivares, Rebecca A.

Siddiqui, Ishreth Fatima

Thackeray, Bridget Yvonne

Ghumman, Umar

Omole, Oluwatosin

Sood, Neil Rohan

Nguyen, Tran

Mittal, Akash

Shi, Yun