Provider Demographics
NPI:1477614303
Name:QURESHI, ATIF (MD)
Entity Type:Individual
Prefix:
First Name:ATIF
Middle Name:
Last Name:QURESHI
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 1:4201 GARTH RD STE 210
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3155
Mailing Address - Country:US
Mailing Address - Phone:281-428-4510
Mailing Address - Fax:
Practice Address - Street 1:4201 GARTH RD STE 210
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3155
Practice Address - Country:US
Practice Address - Phone:281-428-4510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01867207R00000X
NC200601867207RC0200X, 207RP1001X
TXP0865207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC144WVOtherBCBS NC
SCN01867Medicaid
TX288622801Medicaid
NCP00867048OtherRR MEDICARE
TXP01027688OtherRR MEDICARE
NC5905610Medicaid
NC2064774Medicare PIN
NC144WVOtherBCBS NC
SCN01867Medicaid