Provider Demographics
NPI:1790948248
Name:HUSAIN, NISREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NISREEN
Middle Name:
Last Name:HUSAIN
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 1:4608 GIBSON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5519
Mailing Address - Country:US
Mailing Address - Phone:817-714-0155
Mailing Address - Fax:
Practice Address - Street 1:16537 SOUTHWEST FREEWAY
Practice Address - Street 2:SUITE 110
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-276-1960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-04
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6367207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217566301Medicaid
TXTXB111571Medicare PIN