Provider Demographics
NPI:1669928248
Name:BASHEIR, YASIR
Entity type:Individual
Prefix:
First Name:YASIR
Middle Name:
Last Name:BASHEIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 SOUTH FIRST AVE SUITE L
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240
Mailing Address - Country:US
Mailing Address - Phone:319-383-4783
Mailing Address - Fax:319-351-2484
Practice Address - Street 1:1570 S 1ST AVE
Practice Address - Street 2:SUITE L
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6012
Practice Address - Country:US
Practice Address - Phone:319-383-4783
Practice Address - Fax:319-351-2484
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA247AD2020172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver