Provider Demographics
NPI:1821152349
Name:SYED A GARDEZI MD
Entity Type:Organization
Organization Name:SYED A GARDEZI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARDEZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-545-8090
Mailing Address - Street 1:1628 CRABB RIVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5890
Mailing Address - Country:US
Mailing Address - Phone:281-545-8090
Mailing Address - Fax:281-545-8339
Practice Address - Street 1:1628 CRABB RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5890
Practice Address - Country:US
Practice Address - Phone:281-545-8090
Practice Address - Fax:281-545-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2955207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI49279Medicare UPIN