Provider Demographics
NPI:1265552145
Name:TABATABAI, SAYED A (MD)
Entity type:Individual
Prefix:
First Name:SAYED
Middle Name:A
Last Name:TABATABAI
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 1:119 MEDICAL PARK LN STE D
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4980
Mailing Address - Country:US
Mailing Address - Phone:936-277-1000
Mailing Address - Fax:936-994-9020
Practice Address - Street 1:119 MEDICAL PARK LN STE D
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4980
Practice Address - Country:US
Practice Address - Phone:936-277-1000
Practice Address - Fax:936-994-9020
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264726-1207RN0300X
TXQ4310207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX422687YS6NMedicare PIN
J400072572Medicare PIN