Provider Demographics
NPI:1952881799
Name:YOUSEF, MOHAMMAD (LSA)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:YOUSEF
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 FM 1960 RD W APT 9302
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5443
Mailing Address - Country:US
Mailing Address - Phone:832-977-4507
Mailing Address - Fax:
Practice Address - Street 1:21216 NORTHWEST FWY STE 250
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4778
Practice Address - Country:US
Practice Address - Phone:832-977-4507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant