Provider Demographics
NPI:1912943788
Name:SYED, GHYASUDDIN (MD)
Entity type:Individual
Prefix:
First Name:GHYASUDDIN
Middle Name:
Last Name:SYED
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 1:4810 N PINE BROOK WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3160
Mailing Address - Country:US
Mailing Address - Phone:281-422-5500
Mailing Address - Fax:281-422-5560
Practice Address - Street 1:2802 GARTH RD
Practice Address - Street 2:SUITE # 109
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3900
Practice Address - Country:US
Practice Address - Phone:281-422-5500
Practice Address - Fax:281-422-5560
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3493207LP2900X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J3390OtherBCBS
TX10000935OtherAMERIGROUP
TX160479501Medicaid
TX7442412OtherAETNA
TXH63855Medicare UPIN
TX8A4445Medicare PIN