Provider Demographics
NPI:1346439338
Name:HUSNA IQBAL MD PA
Entity Type:Organization
Organization Name:HUSNA IQBAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSNA
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-572-8150
Mailing Address - Street 1:2801 DUKE OF GLOUCESTER ST
Mailing Address - Street 2:ST 101
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2084
Mailing Address - Country:US
Mailing Address - Phone:972-572-8150
Mailing Address - Fax:972-572-8055
Practice Address - Street 1:2801 DUKE OF GLOUCESTER ST
Practice Address - Street 2:ST 101
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2084
Practice Address - Country:US
Practice Address - Phone:972-572-8150
Practice Address - Fax:972-572-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3253207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164139101Medicaid
TX164139102Medicaid
TX164139102Medicaid
TX00541VMedicare PIN
TX164139101Medicaid