Provider Demographics
NPI:1104616416
Name:SUPERHEALTH MEDICAL PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:SUPERHEALTH MEDICAL PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS HEAD
Authorized Official - Prefix:MR
Authorized Official - First Name:REHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EIJAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-301-2036
Mailing Address - Street 1:5900 S LAKE FOREST DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2238
Mailing Address - Country:US
Mailing Address - Phone:469-833-3592
Mailing Address - Fax:210-939-4384
Practice Address - Street 1:5900 S LAKE FOREST DR STE 300
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2238
Practice Address - Country:US
Practice Address - Phone:469-833-3592
Practice Address - Fax:210-939-4384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty