Provider Demographics
NPI:1124435987
Name:BUSHNAQ, SAIF ABDEL RAOUF A (MD)
Entity type:Individual
Prefix:
First Name:SAIF
Middle Name:ABDEL RAOUF A
Last Name:BUSHNAQ
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 1:3601 4TH ST STOP 8321
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8321
Mailing Address - Country:US
Mailing Address - Phone:806-743-3849
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST STOP 8321
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-2674
Practice Address - Country:US
Practice Address - Phone:806-743-3849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS92732084N0400X, 2084V0102X, 2084N0400X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology