Provider Demographics
NPI:1225220783
Name:LAL, YASIR (MD)
Entity type:Individual
Prefix:
First Name:YASIR
Middle Name:
Last Name:LAL
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 1:218 LOVE BIRD LN
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3253
Mailing Address - Country:US
Mailing Address - Phone:605-521-6506
Mailing Address - Fax:
Practice Address - Street 1:600 E TAYLOR ST STE 103
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2810
Practice Address - Country:US
Practice Address - Phone:903-893-7170
Practice Address - Fax:903-893-4372
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND16009207RN0300X, 207RN0300X
MN54173207RN0300X
TXP8689207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6005853Medicaid
SDS102548OtherMEDICARE PTAN
SDS102548OtherMEDICARE PTAN