Provider Demographics
NPI:1619006418
Name:SHARIQ J RAUF MD PA
Entity Type:Organization
Organization Name:SHARIQ J RAUF MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARIQ
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-409-4090
Mailing Address - Street 1:PO BOX 590104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77259-0104
Mailing Address - Country:US
Mailing Address - Phone:713-409-4090
Mailing Address - Fax:281-335-4529
Practice Address - Street 1:2802 GARTH RD
Practice Address - Street 2:SUITE 111
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3900
Practice Address - Country:US
Practice Address - Phone:713-409-4090
Practice Address - Fax:281-335-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1906207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103467004Medicaid
TX103467004Medicaid