Provider Demographics
NPI:1063488500
Name:TEJANI, YASMIN PYARALI (DO)
Entity Type:Individual
Prefix:DR
First Name:YASMIN
Middle Name:PYARALI
Last Name:TEJANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:YASMIN
Other - Middle Name:PYARALI
Other - Last Name:TEJANI-THOMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1012 N GALLOWAY AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-7414
Mailing Address - Country:US
Mailing Address - Phone:972-288-7337
Mailing Address - Fax:972-289-9076
Practice Address - Street 1:1012 N GALLOWAY AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-7414
Practice Address - Country:US
Practice Address - Phone:972-288-7337
Practice Address - Fax:972-289-9076
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5950208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYVAD000Medicare UPIN