Provider Demographics
NPI:1750183331
Name:SOUBRA, YASMINE
Entity type:Individual
Prefix:
First Name:YASMINE
Middle Name:
Last Name:SOUBRA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8447 JOHN SHARP PKWY
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77807-1552
Mailing Address - Country:US
Mailing Address - Phone:979-436-0200
Mailing Address - Fax:
Practice Address - Street 1:2121 W HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3303
Practice Address - Country:US
Practice Address - Phone:713-677-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program