Provider Demographics
NPI:1306023924
Name:NIKHAT A. QURESHI, M.D., P.A.
Entity Type:Organization
Organization Name:NIKHAT A. QURESHI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKHAT
Authorized Official - Middle Name:A
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-370-9800
Mailing Address - Street 1:4255 BRYANT IRVIN RD., #102
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109
Mailing Address - Country:US
Mailing Address - Phone:817-370-9800
Mailing Address - Fax:817-346-1227
Practice Address - Street 1:4255 BRYANT IRVIN RD STE 102
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4224
Practice Address - Country:US
Practice Address - Phone:817-370-9800
Practice Address - Fax:817-346-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9192207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00A54CMedicare PIN
TXC20754Medicare UPIN