Provider Demographics
NPI:1982852166
Name:HUSSAIN, YESSAR MUFEED (MD)
Entity Type:Individual
Prefix:
First Name:YESSAR
Middle Name:MUFEED
Last Name:HUSSAIN
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 1:4705 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8402
Mailing Address - Country:US
Mailing Address - Phone:512-920-0140
Mailing Address - Fax:512-920-0142
Practice Address - Street 1:4705 SPICEWOOD SPRINGS RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8402
Practice Address - Country:US
Practice Address - Phone:512-920-0140
Practice Address - Fax:512-920-0142
Is Sole Proprietor?:No
Enumeration Date:2008-08-30
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2678204R00000X, 2084N0400X, 2084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX302890401Medicaid
TX302890402Medicaid
TXTXB166819Medicare PIN
TX302890401Medicaid
TX302890402Medicaid