Provider Demographics
NPI:1982674206
Name:DURRANI, OMAR HAYAT (MD)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:HAYAT
Last Name:DURRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12121 RICHMOND AVE
Mailing Address - Street 2:SUITE 221
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2432
Mailing Address - Country:US
Mailing Address - Phone:281-589-7175
Mailing Address - Fax:281-589-7903
Practice Address - Street 1:12121 RICHMOND AVE
Practice Address - Street 2:SUITE 221
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2432
Practice Address - Country:US
Practice Address - Phone:281-589-7175
Practice Address - Fax:281-589-7903
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1648208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175686801Medicaid
TX8J0041OtherBLUE CROSS BLUE SHIELD
TX8J0041OtherBLUE CROSS BLUE SHIELD
TX8D8851Medicare ID - Type Unspecified