Provider Demographics
NPI:1083489272
Name:HAYAT CLINIC PLLC
Entity type:Organization
Organization Name:HAYAT CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BASHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOALLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:320-774-1041
Mailing Address - Street 1:3405 3RD ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4015
Mailing Address - Country:US
Mailing Address - Phone:320-774-1041
Mailing Address - Fax:320-774-1049
Practice Address - Street 1:3405 3RD ST N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4015
Practice Address - Country:US
Practice Address - Phone:320-774-1041
Practice Address - Fax:320-774-1049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center