Provider Demographics
NPI:1194706291
Name:YUSUF, QAISER JAMAL (MD)
Entity type:Individual
Prefix:
First Name:QAISER
Middle Name:JAMAL
Last Name:YUSUF
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 1:2306 N ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-3455
Mailing Address - Country:US
Mailing Address - Phone:281-428-7246
Mailing Address - Fax:281-422-3625
Practice Address - Street 1:2306 N ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-3455
Practice Address - Country:US
Practice Address - Phone:281-428-7246
Practice Address - Fax:281-422-3625
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ18182084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13907000Medicaid
TXF23304Medicare UPIN
TX13907000Medicaid