Provider Demographics
NPI:1043839483
Name:YOUSSEF, MINA (MD)
Entity type:Individual
Prefix:DR
First Name:MINA
Middle Name:
Last Name:YOUSSEF
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 1:130 RICK FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2841
Mailing Address - Country:US
Mailing Address - Phone:915-215-4758
Mailing Address - Fax:915-215-8641
Practice Address - Street 1:130 RICK FRANCIS ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2841
Practice Address - Country:US
Practice Address - Phone:915-215-4758
Practice Address - Fax:915-215-8641
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2024-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325438207R00000X
TXBP10090494390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine