Provider Demographics
NPI:1942543384
Name:INSTITUTE OF DIABETES HORMONE AND METABOLISM, PA
Entity Type:Organization
Organization Name:INSTITUTE OF DIABETES HORMONE AND METABOLISM, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:NAVEED
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-626-2470
Mailing Address - Street 1:PO BOX 2228
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-6159
Mailing Address - Country:US
Mailing Address - Phone:940-626-2470
Mailing Address - Fax:940-626-2471
Practice Address - Street 1:902 PRESKITT RD STE 100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-4101
Practice Address - Country:US
Practice Address - Phone:940-626-2470
Practice Address - Fax:940-626-2471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-04
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5190207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX323773702Medicaid
TX323772901Medicaid
TX0098YUOtherBCBSTX