Provider Demographics
NPI:1528595428
Name:SPECTRUM HOUSE CALL PHYSICIANS LLC
Entity Type:Organization
Organization Name:SPECTRUM HOUSE CALL PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALTAMASH
Authorized Official - Middle Name:
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-882-9794
Mailing Address - Street 1:4425 W AIRPORT FWY STE 119
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-5816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4425 W AIRPORT FWY STE 119
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5816
Practice Address - Country:US
Practice Address - Phone:314-882-9794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty