Provider Demographics
NPI:1689650970
Name:BISHARA, MAHER (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHER
Middle Name:
Last Name:BISHARA
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 1:1140 BUSINESS CENTER DR
Mailing Address - Street 2:#100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2737
Mailing Address - Country:US
Mailing Address - Phone:713-464-7768
Mailing Address - Fax:713-464-2436
Practice Address - Street 1:1140 BUSINESS CENTER DR
Practice Address - Street 2:#100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-2737
Practice Address - Country:US
Practice Address - Phone:713-464-7768
Practice Address - Fax:713-464-2436
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6732207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131628306Medicaid
TX131628306Medicaid
TX00L83ZMedicare PIN