Provider Demographics
NPI:1780649905
Name:NAYEEM, QASIM (MD)
Entity Type:Individual
Prefix:
First Name:QASIM
Middle Name:
Last Name:NAYEEM
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 1:5417 BENTROSE DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8877
Mailing Address - Country:US
Mailing Address - Phone:214-548-6388
Mailing Address - Fax:
Practice Address - Street 1:5417 BENTROSE DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8877
Practice Address - Country:US
Practice Address - Phone:214-548-6388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8865207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AN633OtherBCBS
KS105430Medicare ID - Type Unspecified
TX8K5251Medicare PIN
KSI51056Medicare UPIN