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NPI Code Detail

MEDICARE: HABEN YISSEHAK PA-C

MEDICARE: HABEN YISSEHAK PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA07011TX

General Provider Information

NPI Number : 1023318870
Entity Type Code : Individual
Provider Name (Legal Business Name) : HABEN YISSEHAK PA-C
Provider Business Mailing Address
First Line : POBOX
Second Line :
City : DALLAS
State : TX
Zip : 75284-7208
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6201 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75235-5202
Country : US
Telephone Number : 214-645-3597
Fax Number : 214-645-3597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2010
Last Update Date : 04/06/2026

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