Provider Demographics
NPI:1881845634
Name:SATTAR, BEENA (MD)
Entity Type:Individual
Prefix:DR
First Name:BEENA
Middle Name:
Last Name:SATTAR
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 1:6431 FANNIN ST # 1.122
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6714
Mailing Address - Fax:713-500-6722
Practice Address - Street 1:11452 SPACE CENTER BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-3599
Practice Address - Country:US
Practice Address - Phone:713-486-6200
Practice Address - Fax:713-486-6294
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD18577207R00000X
TXQ4274207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX352170001Medicaid
ME1881845634Medicaid
TX448261YKY3Medicare PIN
ME001854601Medicare PIN