Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | Q7596 | TX |
NPI | 1003175886 |
---|---|
Provider Name | Syeda Quadri |
First Address | Mesquite, TX 75149-2438 |
Second Address | Lombard, IL 60148-4630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2012 |
Last Update Date | 28/12/2021 |