Provider Demographics
NPI:1942308002
Name:YUNUS, TARIQ M (MD)
Entity Type:Individual
Prefix:
First Name:TARIQ
Middle Name:M
Last Name:YUNUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 S. FREEWAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028
Mailing Address - Country:US
Mailing Address - Phone:817-293-9009
Mailing Address - Fax:817-293-9013
Practice Address - Street 1:12001 S. FREEWAY
Practice Address - Street 2:SUITE 201
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76026
Practice Address - Country:US
Practice Address - Phone:817-293-9009
Practice Address - Fax:817-293-9013
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4677207Y00000X, 207YP0228X, 207YS0012X, 207YX0007X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00421658OtherRAIL ROAD MEDICARE
TX187320001Medicaid
TX8F5657Medicare PIN