Healthcare Provider Details

I. General information

NPI: 1790311959
Provider Name (Legal Business Name): SOZIT YOUSUF PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 E PRESIDENT GEORGE BUSH HWY
RICHARDSON TX
75082-3561
US

IV. Provider business mailing address

2805 E PRESIDENT GEORGE BUSH HWY
RICHARDSON TX
75082-3561
US

V. Phone/Fax

Practice location:
  • Phone: 469-204-5620
  • Fax: 214-947-8315
Mailing address:
  • Phone: 469-204-5620
  • Fax: 214-947-8315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA13894
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: