Healthcare Provider Details

I. General information

NPI: 1417849811
Provider Name (Legal Business Name): NOA YAEL YIZHARI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9719 ATWELL DR
HOUSTON TX
77096-3902
US

IV. Provider business mailing address

5300 N BRAESWOOD BLVD # 4-245
HOUSTON TX
77096-3307
US

V. Phone/Fax

Practice location:
  • Phone: 832-707-9696
  • Fax:
Mailing address:
  • Phone: 832-707-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number728589
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: