Provider Demographics
NPI:1225695885
Name:YUSUF, SAMIR ZAKI (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMIR
Middle Name:ZAKI
Last Name:YUSUF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MYRTLE AVE APT 2203
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79901-1672
Mailing Address - Country:US
Mailing Address - Phone:469-463-7281
Mailing Address - Fax:
Practice Address - Street 1:5631 DYER ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-6204
Practice Address - Country:US
Practice Address - Phone:915-245-3517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX63476OtherTSBP