MEDICARE: DR. ALTAIB AL YASSIN

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	207RG0100X	Gastroenterology Physician	U7821	TX

General Provider Information

NPI Number	:	1972008134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALTAIB AL YASSIN

Provider Business Mailing Address
First Line	:	16537 SOUTHWEST FWY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7238
Country	:	US
Telephone Number	:	281-276-1960
Fax Number	:

Provider Business Practice Location Address
First Line	:	16537 SOUTHWEST FWY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7238
Country	:	US
Telephone Number	:	281-276-1960
Fax Number	:

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

Provider Enumeration Date	:	03/28/2018
Last Update Date	:	05/26/2026

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