Provider Demographics
NPI:1467401026
Name:HUQ, NISAR MIKAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:NISAR
Middle Name:MIKAIL
Last Name:HUQ
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 51225
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-1225
Mailing Address - Country:US
Mailing Address - Phone:806-352-7200
Mailing Address - Fax:806-352-3411
Practice Address - Street 1:1215 S COULTER ST STE 302
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1768
Practice Address - Country:US
Practice Address - Phone:806-352-7200
Practice Address - Fax:806-352-3411
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0761207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176881401Medicaid
TX176881401Medicaid
TX8K8760Medicare PIN
TX8D8922Medicare ID - Type UnspecifiedMEDICARE