Provider Demographics
NPI:1053674408
Name:ABDUL GHAFFAR, YASIR (MD)
Entity type:Individual
Prefix:
First Name:YASIR
Middle Name:
Last Name:ABDUL GHAFFAR
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 1:7390 BARLITE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1338
Mailing Address - Country:US
Mailing Address - Phone:210-921-0000
Mailing Address - Fax:210-921-0001
Practice Address - Street 1:7390 BARLITE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1338
Practice Address - Country:US
Practice Address - Phone:210-921-0000
Practice Address - Fax:210-921-0001
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU4725207RC0000X, 207RI0011X
IN01075795A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN264910085Medicare PIN