Provider Demographics
NPI:1275162992
Name:RIZVI, SYEDA TALIYA HASAN (MD)
Entity Type:Individual
Prefix:
First Name:SYEDA TALIYA
Middle Name:HASAN
Last Name:RIZVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 SALADA DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-8846
Mailing Address - Country:US
Mailing Address - Phone:224-310-0939
Mailing Address - Fax:
Practice Address - Street 1:1820 N LAKE FOREST DR STE 300
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7653
Practice Address - Country:US
Practice Address - Phone:214-491-5606
Practice Address - Fax:972-746-4778
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-04
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU2621207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine