Basic Information
| Provider Information | |||||||||
| NPI: | 1225220783 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAL | ||||||||
| FirstName: | YASIR | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3571 W WHEATLAND RD | ||||||||
| Address2: | STE 101 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752373461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 E BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | BISMARCK | ||||||||
| State: | ND | ||||||||
| PostalCode: | 585014520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7015307000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2007 | ||||||||
| LastUpdateDate: | 10/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 54173 | MN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 208M00000X | 7271 | SD | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RN0300X | P8689 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 16009 | ND | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 6005853 | 05 | SD | MEDICAID | S102548 | 01 | SD | MEDICARE PTAN | OTHER |