Provider Demographics
NPI:1417962887
Name:ZURIQAT, MUQDAD A (MD)
Entity Type:Individual
Prefix:
First Name:MUQDAD
Middle Name:A
Last Name:ZURIQAT
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 1:300 N HIGHLAND AVE
Mailing Address - Street 2:SUITE 455
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7388
Mailing Address - Country:US
Mailing Address - Phone:903-868-2800
Mailing Address - Fax:903-868-2822
Practice Address - Street 1:300 N HIGHLAND AVE
Practice Address - Street 2:SUITE 455
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7388
Practice Address - Country:US
Practice Address - Phone:903-868-2800
Practice Address - Fax:903-868-2822
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8455174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00464252OtherRAIL ROAD MEDICARE
TX8AS630OtherBLUE CROSS BLUE SHIELD
TXP00464252OtherRAIL ROAD MEDICARE
TX8F7102Medicare PIN
TX8AS630OtherBLUE CROSS BLUE SHIELD