Provider Demographics
NPI:1790945426
Name:TOPIWALA-HATHIYARI, TASNIM (MD)
Entity Type:Individual
Prefix:
First Name:TASNIM
Middle Name:
Last Name:TOPIWALA-HATHIYARI
Suffix:
Gender:F
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 57845
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-7845
Mailing Address - Country:US
Mailing Address - Phone:281-724-1862
Mailing Address - Fax:281-724-1859
Practice Address - Street 1:600 N KOBAYASHI STE 213
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4841
Practice Address - Country:US
Practice Address - Phone:281-724-1862
Practice Address - Fax:281-724-1859
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1147207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX304432302Medicaid
TX8EJ194OtherBCBSTX
TXP01340845OtherRR MEDICARE
TX304432302Medicaid
TX8DG861OtherBCBS-TX
MA2158035Medicaid
TX304432301Medicaid