Provider Demographics
NPI:1073686325
Name:TADIA, RIAZ YUSUF (MD)
Entity Type:Individual
Prefix:DR
First Name:RIAZ
Middle Name:YUSUF
Last Name:TADIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:910 E HOUSTON ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-8369
Mailing Address - Country:US
Mailing Address - Phone:903-525-7995
Mailing Address - Fax:903-525-7929
Practice Address - Street 1:420 DELAWARE ST SE
Practice Address - Street 2:SUITE 205
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0341
Practice Address - Country:US
Practice Address - Phone:612-625-6519
Practice Address - Fax:612-625-7950
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2014-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN60562084N0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program