Provider Demographics
NPI:1205938867
Name:UDDIN, SAID NONE (MD)
Entity type:Individual
Prefix:
First Name:SAID
Middle Name:NONE
Last Name:UDDIN
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 1:11301 FALLBROOK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4237
Mailing Address - Country:US
Mailing Address - Phone:281-897-9966
Mailing Address - Fax:281-897-8806
Practice Address - Street 1:11301 FALLBROOK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4237
Practice Address - Country:US
Practice Address - Phone:281-897-9966
Practice Address - Fax:281-897-8806
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8542207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046766402Medicaid
TX45-0472287OtherTAX ID NUMBER
TXG56022Medicare UPIN
TX00318UMedicare ID - Type Unspecified