1528002896 NPI number — SEEMA Y HAQUE M D P A

Table of content: (NPI 1528002896)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528002896 NPI number — SEEMA Y HAQUE M D P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SEEMA Y HAQUE M D P A
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528002896
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 250885
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75025-0885
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-719-3769
Provider Business Mailing Address Fax Number:
866-262-1819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
902 W RANDOL MILL RD
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76012-2572
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-719-3769
Provider Business Practice Location Address Fax Number:
866-262-1819
Provider Enumeration Date:
06/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HAQUE
Authorized Official First Name:
SEEMA
Authorized Official Middle Name:
YASMEEN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
817-719-3769

Provider Taxonomy Codes

  • Taxonomy code: 2084P0805X , with the licence number:  K9077 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 169294902 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 169294901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 169294903 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 169294904 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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