Healthcare Provider Details

I. General information

NPI: 1780935817
Provider Name (Legal Business Name): SYED A YUSOOF MHT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 N MESA ST
EL PASO TX
79902-3527
US

IV. Provider business mailing address

1515 HERITAGE DRIVE SUITE 110
MCKINNEY TX
75069-3379
US

V. Phone/Fax

Practice location:
  • Phone: 254-654-3719
  • Fax:
Mailing address:
  • Phone: 855-860-2109
  • Fax: 855-814-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberJ8176
License Number StateTX

VIII. Authorized Official

Name: SYED A YUSOOF
Title or Position: OWNER
Credential: M.D.
Phone: 915-533-0406