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General NPI Number Information
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NPI Number | 1356377816
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Entity Type | Individual
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Provider Name | YAZAN A ABU QWAIDER MD
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Gender | Male
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 17350 ST LUKES WAY STE 200
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City | THE WOODLANDS
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State | TX
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Zip | 77384-4103
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Country | US
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Telephone | 936-266-2630
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 HIGHWAY 90
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City | GAUTIER
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State | MS
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Zip | 39553-5340
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Country | US
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Telephone | 228-497-7576
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Fax | 228-497-8869
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 2021032798
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 01054577A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 30770
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | L3549
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License Number State | TX
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