Provider Demographics
NPI:1851590954
Name:MUMTAZ SULEMAN, M.D., P.A.
Entity Type:Organization
Organization Name:MUMTAZ SULEMAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:MUMTAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SULEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-316-6501
Mailing Address - Street 1:2060 SPACE PARK DR
Mailing Address - Street 2:SUITE 404
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3600
Mailing Address - Country:US
Mailing Address - Phone:281-316-6501
Mailing Address - Fax:281-339-7180
Practice Address - Street 1:2060 SPACE PARK DR
Practice Address - Street 2:SUITE 404
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3600
Practice Address - Country:US
Practice Address - Phone:281-316-6501
Practice Address - Fax:281-339-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL61902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157680302Medicaid
TX00Y620Medicare PIN