Provider Demographics
NPI:1750450342
Name:HASAN, SYED W (MD)
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:W
Last Name:HASAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11914 ASTORIA BLVD
Mailing Address - Street 2:STE #185
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6064
Mailing Address - Country:US
Mailing Address - Phone:281-922-7377
Mailing Address - Fax:281-922-7979
Practice Address - Street 1:11914 ASTORIA BLVD
Practice Address - Street 2:STE #185
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6064
Practice Address - Country:US
Practice Address - Phone:281-922-7377
Practice Address - Fax:281-922-7979
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM2972207RI0200X
PAMD431253207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA082109OtherMEDICARE PTAN/GROUP NUMBER
PA101927790Medicaid
PA101927790Medicaid