Provider Demographics
NPI:1710149372
Name:SYED R HUSAIN MD,PA
Entity Type:Organization
Organization Name:SYED R HUSAIN MD,PA
Other - Org Name:VALLEY PEDIATRIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:RASHID
Authorized Official - Last Name:HUSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-330-9707
Mailing Address - Street 1:7020 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-1928
Mailing Address - Country:US
Mailing Address - Phone:956-424-7100
Mailing Address - Fax:956-424-7111
Practice Address - Street 1:3005 N CONWAY AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-2103
Practice Address - Country:US
Practice Address - Phone:956-424-7100
Practice Address - Fax:956-424-7111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1777208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty