Provider Demographics
NPI:1376503193
Name:RAZA, SYED A (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:A
Last Name:RAZA
Suffix:
Gender:M
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:PO BOX 9922
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-6922
Mailing Address - Country:US
Mailing Address - Phone:281-419-5818
Mailing Address - Fax:281-465-4596
Practice Address - Street 1:1111 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 250
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3240
Practice Address - Country:US
Practice Address - Phone:281-419-5818
Practice Address - Fax:281-465-4596
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7472207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149224104Medicaid
TX185224601Medicaid
TX8F4593Medicare PIN
TX8F2393Medicare PIN
TX149224104Medicaid