Provider Demographics
NPI:1083746168
Name:SYED, WAQAR (MD)
Entity Type:Individual
Prefix:
First Name:WAQAR
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 1:10864 TEXAS HEALTH TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4897
Mailing Address - Country:US
Mailing Address - Phone:682-212-3160
Mailing Address - Fax:682-212-9301
Practice Address - Street 1:10864 TEXAS HEALTH TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4897
Practice Address - Country:US
Practice Address - Phone:682-212-3160
Practice Address - Fax:682-212-9301
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16054207R00000X
LA12732R207R00000X
TXP3254207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX326889802Medicaid
MS00119855Medicaid
MSBS613627OtherDEA NUMBER
MS930000898Medicare ID - Type UnspecifiedMEDICARE MS
MS00119855Medicaid
TX316746YKN5Medicare PIN