Provider Demographics
NPI:1821069170
Name:HUSSAIN, MAHAMMAD NAUSHAD (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHAMMAD
Middle Name:NAUSHAD
Last Name:HUSSAIN
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 1:1737 BRIARCREST DR
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2769
Mailing Address - Country:US
Mailing Address - Phone:979-776-4777
Mailing Address - Fax:
Practice Address - Street 1:1737 BRIARCREST DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2769
Practice Address - Country:US
Practice Address - Phone:979-776-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235125207L00000X
TXP1653207L00000X
TXFTL42601207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AA339OtherBCBSTX
TX196140101Medicaid
TX196140102OtherCSHCN
TX196140102OtherCSHCN
TXP00690758Medicare PIN
NYRA8330Medicare PIN
TX8K6614Medicare PIN