Provider Demographics
NPI:1760465553
Name:A. SATTAR, MUHAMMAD AIJAZ (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:AIJAZ
Last Name:A. SATTAR
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:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3310 LIVE OAK ST
Practice Address - Street 2:COOC FLOAT
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6153
Practice Address - Country:US
Practice Address - Phone:214-266-1000
Practice Address - Fax:214-266-1246
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9472207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177467102Medicaid
TX8U7225OtherBLUE CROSS BLUE SHIELD
TXP00279651OtherRAILROAD MEDICARE
TX177467101Medicaid
TXP00279651OtherRAILROAD MEDICARE
TX177467101Medicaid