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Farida N/A Yoosefian

Internal Medicine

Allopathic & Osteopathic Physicians

1515 Truemper St, Lackland A F B, TX 78236-5583

PECOS Enrollment

This provider is enrolled in PECOS as FARIDA YOOSEFIAN.

Based on the most recent information from CMS, provider Farida N/A Yoosefian is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1558333831
Provider Type
Individual
Full Name
Yoosefian, Farida N/A
Credential
M.D.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/2/2006
Last Updated
11/10/2011

Contact Information

Practice Location

1515 Truemper St, Lackland A F B, TX 78236-5583

(210) 671-9556

Unlisted Fax

Mailing Location

1515 Truemper Street, 559 Amds/Sgpf, San Antonio, TX 78236

(210) 671-5513

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 36538 Wisconsin
Code 207P00000X	Description Emergency Medicine Allopathic & Osteopathic Physicians	License N6115 Texas

Farida N/A Yoosefian

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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