Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 4301075652 | MI |
NPI | 1053462069 |
---|---|
Provider Name | Dr. Saqib I Hasan |
First Address | Dallas, TX 75373-2973 |
Second Address | Fort Worth, TX 76104-7663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 13/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4203001 | (05) | MI |
G29243 | (02) |