Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | M4677 | TX |
N | 207YP0228X | Pediatric Otolaryngology | M4677 | TX |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | M4677 | TX |
NPI | 1942308002 |
---|---|
Provider Name | Tariq M Yunus |
First Address | Burleson, TX 76028 |
Second Address | Burleson, TX 76026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 09/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
187320001 | (05) | TX |
P00421658 | RAIL ROAD MEDICARE (01) | TX |