Provider Demographics
NPI:1144417569
Name:RAZA, SYED SADI (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:SADI
Last Name:RAZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SADI
Other - Middle Name:
Other - Last Name:RAZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:16980 DALLAS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1908
Mailing Address - Country:US
Mailing Address - Phone:972-391-1915
Mailing Address - Fax:844-290-4358
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE A-341
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:972-566-5700
Practice Address - Fax:844-290-4358
Is Sole Proprietor?:No
Enumeration Date:2007-09-30
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420012069207R00000X
TXQ1003207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX339581601Medicaid
TX363917YSHRMedicare PIN