Provider Demographics
NPI:1730860412
Name:NOFAL, YAZAN HOUSSEIN (MD)
Entity type:Individual
Prefix:
First Name:YAZAN
Middle Name:HOUSSEIN
Last Name:NOFAL
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 1:7200 CAMBRIDGE STREET, 9A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-798-6628
Mailing Address - Fax:713-798-7561
Practice Address - Street 1:7200 CAMBRIDGE STREET, 9A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-798-6628
Practice Address - Fax:713-798-7561
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program