MEDICARE: KHALIDA N/A YASMIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	K7124	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8W8853	OTHER	TX	BCBS
2	1275234437	OTHER	TX	NPI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1790362531	OTHER	TX	NPI

General Provider Information

NPI Number	:	1306842216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHALIDA N/A YASMIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 261724
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75026-1724
Country	:	US
Telephone Number	:	972-292-0300
Fax Number	:	972-292-0301

Provider Business Practice Location Address
First Line	:	2601 LITTLE ELM PKWY STE 1204
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-1921
Country	:	US
Telephone Number	:	972-292-0300
Fax Number	:	972-292-0301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	08/30/2024

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