Provider Demographics
NPI:1164620415
Name:BISSONNET MEDICAL CENTER PA
Entity Type:Organization
Organization Name:BISSONNET MEDICAL CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:281-575-6700
Mailing Address - Street 1:11327 BISSONNET ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-2049
Mailing Address - Country:US
Mailing Address - Phone:281-575-6700
Mailing Address - Fax:281-564-1800
Practice Address - Street 1:11327 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-2049
Practice Address - Country:US
Practice Address - Phone:281-575-6700
Practice Address - Fax:281-564-1800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4240261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00074GMedicare PIN
TXG67459Medicare UPIN