Provider Demographics
NPI:1073060331
Name:ID CLINIC CONSULTANTS PLLC
Entity Type:Organization
Organization Name:ID CLINIC CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAKIR HUSSAIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-947-3200
Mailing Address - Street 1:908 AUDELIA RD
Mailing Address - Street 2:STE 200 #323
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5166
Mailing Address - Country:US
Mailing Address - Phone:972-947-3200
Mailing Address - Fax:972-947-3201
Practice Address - Street 1:908 AUDELIA RD
Practice Address - Street 2:STE 200 #323
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5166
Practice Address - Country:US
Practice Address - Phone:972-947-3200
Practice Address - Fax:972-947-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-04
Last Update Date:2016-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9168207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty