Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | R1460 | TX |
NPI | 1003915802 |
---|---|
Provider Name | Khalid H Syed |
First Address | Fort Worth, TX 76114-1756 |
Second Address | Fort Worth, TX 76114-1756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 22/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01639270 | (05) | NY |
374935001 | (05) | TX |
D93276 | UPIN (01) | NY |