Provider Demographics
NPI:1255327714
Name:YACOUBY, SAEED MAHMOUD (CRNA)
Entity Type:Individual
Prefix:MR
First Name:SAEED
Middle Name:MAHMOUD
Last Name:YACOUBY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2807 PLANTATION LAKES DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4333
Mailing Address - Country:US
Mailing Address - Phone:832-814-1480
Mailing Address - Fax:832-814-1480
Practice Address - Street 1:6431 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-500-6202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX613451367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX053226OtherRAILROAD MEDICARE
TX8D5819Medicaid
TX85192UOtherBLUE CROSS BLUE SHIELD
TX154545102Medicaid
TXP00231340OtherRAILROAD MEDICARE
TX8D5104Medicare ID - Type Unspecified