Provider Demographics
NPI:1013203801
Name:WARDAK, MAHEEN ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHEEN
Middle Name:ADAM
Last Name:WARDAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:6565 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-441-2194
Practice Address - Fax:713-441-1495
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN8470207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8EC774OtherBCBS
TX288369602Medicaid
TXP01305888OtherRR MEDICARE
TX338266YK6UMedicare PIN