Provider Demographics
NPI:1598966715
Name:BUTT, QASIM A (MD)
Entity type:Individual
Prefix:
First Name:QASIM
Middle Name:A
Last Name:BUTT
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 1:8918 RIVER TRCE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2380
Mailing Address - Country:US
Mailing Address - Phone:210-913-0382
Mailing Address - Fax:
Practice Address - Street 1:7703 FLOYD CURL DR # 7882
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-567-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0446074207RN0300X
TXN7528207RN0300X
NMMD2024-0241207RN0300X
ARE15720207RN0300X
WAMD61272007207RN0300X
LA338142207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX215184701Medicare PIN
TXTXB106935Medicare PIN