Provider Demographics
NPI:1558301770
Name:HAQ, NADEEM (MD)
Entity Type:Individual
Prefix:
First Name:NADEEM
Middle Name:
Last Name:HAQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3311 UNICORN LAKE BLVD
Mailing Address - Street 2:SUITE 181
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0102
Mailing Address - Country:US
Mailing Address - Phone:940-323-2020
Mailing Address - Fax:940-323-2011
Practice Address - Street 1:3311 UNICORN LAKE BLVD
Practice Address - Street 2:SUITE 181
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0102
Practice Address - Country:US
Practice Address - Phone:940-323-2020
Practice Address - Fax:940-323-2011
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL8360207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184740201Medicaid
TX184740201Medicaid
TX8F4108Medicare PIN