Provider Demographics
NPI:1326034802
Name:KAYYAS, YOUSEF (MD)
Entity Type:Individual
Prefix:
First Name:YOUSEF
Middle Name:
Last Name:KAYYAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YOUSEF
Other - Middle Name:
Other - Last Name:ABOU KAYYAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1611 N BELTLINE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-1792
Mailing Address - Country:US
Mailing Address - Phone:972-288-3471
Mailing Address - Fax:972-288-7445
Practice Address - Street 1:1611 N BELT LINE RD
Practice Address - Street 2:SUITE C
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1793
Practice Address - Country:US
Practice Address - Phone:972-288-3471
Practice Address - Fax:972-288-7445
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9004174400000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK9004OtherTEXAS LICENSE
TX047594902Medicaid
TX290013608OtherRR MEDICARE
TX99GHOtherBLUE CROSS BLUE SHIELD GR
TX99GHOtherBLUE CROSS BLUE SHIELD GR
TXK9004OtherTEXAS LICENSE
TX00711MMedicare PIN