Provider Demographics
NPI:1306050935
Name:HUSSAIN, SYED N (MBBS)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:N
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2228
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-6159
Mailing Address - Country:US
Mailing Address - Phone:940-626-2470
Mailing Address - Fax:940-626-2471
Practice Address - Street 1:902 PRESKITT RD STE 100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-4101
Practice Address - Country:US
Practice Address - Phone:940-626-2470
Practice Address - Fax:940-626-2471
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN50662207RE0101X
TXP5190207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX323773702Medicaid
TX8DU197OtherBCBSTX
TX323773701Medicaid