Basic Information
| Provider Information | |||||||||
| NPI: | 1710284252 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YOUSUF J ALLAWALA, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26311 REYGLEN DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782553548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106989472 | ||||||||
| FaxNumber: | 3307824750 | ||||||||
| Practice Location | |||||||||
| Address1: | 17720 CORPORATE WOODS DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782593500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104919400 | ||||||||
| FaxNumber: | 3307824750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2011 | ||||||||
| LastUpdateDate: | 12/16/2016 | ||||||||
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| AuthorizedOfficialLastName: | ALLAWALA | ||||||||
| AuthorizedOfficialFirstName: | YOUSUF | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2106989472 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | J9946 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 047098103 | 05 | TX | MEDICAID |