Provider Demographics
NPI:1316139660
Name:DARKAZALLY, MHD YASSER (MD)
Entity type:Individual
Prefix:
First Name:MHD YASSER
Middle Name:
Last Name:DARKAZALLY
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 1:4512 SHADE TREE CT
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-4597
Mailing Address - Country:US
Mailing Address - Phone:918-810-2524
Mailing Address - Fax:
Practice Address - Street 1:4017 E PLANO PKWY STE 400
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-1841
Practice Address - Country:US
Practice Address - Phone:972-379-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26163207R00000X, 208M00000X
TXV2052207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOK401166Medicare Oscar/Certification