Provider Demographics
NPI:1063412807
Name:RIZVI, SYED HASSAN MEHDI (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:HASSAN MEHDI
Last Name:RIZVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 FROSTWOOD DR STE 142
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2401
Mailing Address - Country:US
Mailing Address - Phone:713-827-8266
Mailing Address - Fax:713-827-0132
Practice Address - Street 1:902 FROSTWOOD DR STE 142
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2401
Practice Address - Country:US
Practice Address - Phone:713-827-8266
Practice Address - Fax:713-827-0132
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK76012080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX760465919OtherTAX ID
TX149432002Medicaid
TX167227101Medicaid
TX1083861231OtherNPI
TXG59370Medicare UPIN
TX167227101Medicaid