Provider Demographics
NPI:1821145871
Name:HUQ, MAHFUZUL (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHFUZUL
Middle Name:
Last Name:HUQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:MAHFUZUL
Other - Middle Name:
Other - Last Name:HUQ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5428 S JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6672
Mailing Address - Country:US
Mailing Address - Phone:956-682-5515
Mailing Address - Fax:956-692-5554
Practice Address - Street 1:1102 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9105
Practice Address - Country:US
Practice Address - Phone:956-388-6000
Practice Address - Fax:956-289-2965
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8738208000000X, 208M00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174025001Medicaid
TX174025008Medicaid