Provider Demographics
NPI:1437631512
Name:SYED, MIDHAT (PA)
Entity Type:Individual
Prefix:
First Name:MIDHAT
Middle Name:
Last Name:SYED
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 INTERWAY PL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-5668
Mailing Address - Country:US
Mailing Address - Phone:817-735-1180
Mailing Address - Fax:866-861-2145
Practice Address - Street 1:4201 INTERWAY PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-5668
Practice Address - Country:US
Practice Address - Phone:817-735-1180
Practice Address - Fax:866-861-2145
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12211363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical