Provider Demographics
NPI:1003170226
Name:HEARTLAND PHYSICIANS ASSOCIATES PLLC
Entity Type:Organization
Organization Name:HEARTLAND PHYSICIANS ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHURRAM
Authorized Official - Middle Name:RAFI
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-346-1969
Mailing Address - Street 1:2222 MARONEAL ST
Mailing Address - Street 2:1716
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3242
Mailing Address - Country:US
Mailing Address - Phone:304-346-1969
Mailing Address - Fax:
Practice Address - Street 1:2222 MARONEAL ST
Practice Address - Street 2:1716
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3242
Practice Address - Country:US
Practice Address - Phone:304-346-1969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN89842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty