Provider Demographics
NPI:1114316429
Name:MARIA VIQAR-SYED, MD PA
Entity Type:Organization
Organization Name:MARIA VIQAR-SYED, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:THORNBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-863-9047
Mailing Address - Street 1:2709 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7549
Mailing Address - Country:US
Mailing Address - Phone:972-303-8437
Mailing Address - Fax:972-867-4279
Practice Address - Street 1:2709 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7549
Practice Address - Country:US
Practice Address - Phone:972-303-8437
Practice Address - Fax:972-867-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0843261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center