1710199872 NPI number — USMAN QURESHI, MD, PA

Table of content: (NPI 1710199872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710199872 NPI number — USMAN QURESHI, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
USMAN QURESHI, MD, PA
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:
ALICE HEART CENTER
Provider Other Organization Name Type Code:
3
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:
1710199872
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1008 MEDICAL CENTER BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALICE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78332-5049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-668-4278
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1008 MEDICAL CENTER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALICE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78332-5049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-668-4278
Provider Business Practice Location Address Fax Number:
361-668-4166
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VILLARREAL
Authorized Official First Name:
LETTY
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCIAL DEPT. MANAGER
Authorized Official Telephone Number:
361-668-4278

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  J8095 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 079669001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0075CG . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com