Healthcare Provider Details

I. General information

NPI: 1609255686
Provider Name (Legal Business Name): MOHAMMAD A YOUSEF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2015
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 38TH ST STE 315
AUSTIN TX
78705-1012
US

IV. Provider business mailing address

1301 W 38TH ST STE 315
AUSTIN TX
78705-1012
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-7831
  • Fax:
Mailing address:
  • Phone: 512-324-7831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMT217167
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number304191
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberU6106
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: