Provider Demographics
NPI:1588046346
Name:USMAN, SADIYA (MBBS)
Entity type:Individual
Prefix:
First Name:SADIYA
Middle Name:
Last Name:USMAN
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10502 BERMUDA ISLE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2720
Mailing Address - Country:US
Mailing Address - Phone:815-517-5376
Mailing Address - Fax:
Practice Address - Street 1:1631 11TH ST UNIT B
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4332
Practice Address - Country:US
Practice Address - Phone:940-263-3000
Practice Address - Fax:940-263-3018
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine