Provider Demographics
NPI:1417905431
Name:HUSSAIN, ATIF (MD)
Entity Type:Individual
Prefix:
First Name:ATIF
Middle Name:
Last Name:HUSSAIN
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 1:2505 SCRIPTURE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2376
Mailing Address - Country:US
Mailing Address - Phone:940-320-2188
Mailing Address - Fax:
Practice Address - Street 1:2505 SCRIPTURE ST STE 100
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2376
Practice Address - Country:US
Practice Address - Phone:940-320-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6953207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G9671OtherBCBS
TX160850701Medicaid
TXP00050854OtherRAILROAD MEDICARE
TX8G9671OtherBCBS
TXP00050854OtherRAILROAD MEDICARE
TX472046YKP5Medicare PIN