MEDICARE: DR. POURAN YOUSEFI M.D.

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
1	207Q00000X	Family Medicine Physician	L0719	TX

General Provider Information

NPI Number	:	1760552590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. POURAN YOUSEFI M.D.

Provider Business Mailing Address
First Line	:	8810 HIGHWAY 6 STE 100
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7104
Country	:	US
Telephone Number	:	713-486-1200
Fax Number	:	281-778-5345

Provider Business Practice Location Address
First Line	:	8810 HIGHWAY 6 STE 100
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7104
Country	:	US
Telephone Number	:	713-486-1200
Fax Number	:	281-778-5345

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	05/13/2022

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