MEDICARE: DR. MICHAEL NESSIM YOUSSEF MD

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	207RX0202X	Medical Oncology Physician	S1024	TX
2	2084N0400X	Neurology Physician	S1024	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790102028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL NESSIM YOUSSEF MD

Provider Business Mailing Address
First Line	:	2201 INWOOD RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7320
Country	:	US
Telephone Number	:	214-645-4673
Fax Number	:	214-645-2615

Provider Business Practice Location Address
First Line	:	6202 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7320
Country	:	US
Telephone Number	:	214-645-4673
Fax Number	:

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

Provider Enumeration Date	:	03/25/2014
Last Update Date	:	05/04/2023

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