Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | K7601 | TX |
NPI | 1063412807 |
---|---|
Provider Name | Syed Hassan Mehdi Rizvi |
First Address | Houston, TX 77024-2401 |
Second Address | Houston, TX 77024-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2005 |
Last Update Date | 18/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083861231 | NPI (01) | TX |
149432002 | (05) | TX |
167227101 | (05) | TX |
760465919 | TAX ID (01) | TX |
G59370 | (02) | TX |