=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548425622
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAWWAD YUSUF MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2008
-----------------------------------------------------
Last Update Date | 11/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8230 WALNUT HILL LN STE 220
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75231-4425
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 143-458-6922
-----------------------------------------------------
Fax | 214-345-0117
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P O BOX 1000 DEPT 960
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38148-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-758-9900
-----------------------------------------------------
Fax | 901-752-2335
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RA0001X
-----------------------------------------------------
Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
-----------------------------------------------------
License Number | Q0391
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | Q0391
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | Q0391
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------