1881697852 NPI number — DR. RIAZ UL HAQUE M.D.

Table of content: DR. RIAZ UL HAQUE M.D. (NPI 1881697852)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881697852 NPI number — DR. RIAZ UL HAQUE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAQUE
Provider First Name:
RIAZ
Provider Middle Name:
UL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1881697852
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7203 TIMBERLAKE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77479-6309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-296-9674
Provider Business Mailing Address Fax Number:
504-754-7574

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2404 SMITH RANCH RD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77584-5233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-436-4333
Provider Business Practice Location Address Fax Number:
844-322-8254
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  M5211 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 15040R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 15040R . This is a "LOUISIANA MEDICAL LICENSE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 345196501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1421014 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: M5211 . This is a "TEXAS MEDICAL LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com