Provider Demographics
NPI:1598293003
Name:HUSSAIN, NIDA (MD)
Entity type:Individual
Prefix:
First Name:NIDA
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 SW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78237-3360
Mailing Address - Country:US
Mailing Address - Phone:210-358-5100
Mailing Address - Fax:210-358-5129
Practice Address - Street 1:2121 SW 36TH ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-3360
Practice Address - Country:US
Practice Address - Phone:210-358-5100
Practice Address - Fax:210-358-5129
Is Sole Proprietor?:No
Enumeration Date:2017-05-28
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS9315207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine