Provider Demographics
NPI:1336200302
Name:CHEEMA, KAUSAR SAYEED (MD)
Entity Type:Individual
Prefix:DR
First Name:KAUSAR
Middle Name:SAYEED
Last Name:CHEEMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:KAUSAR
Other - Middle Name:
Other - Last Name:SHAHNAZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:36000 DARNALL LOOP
Mailing Address - Street 2:CRDAMC
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-288-8025
Mailing Address - Fax:254-286-7326
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-5095
Practice Address - Country:US
Practice Address - Phone:254-288-8025
Practice Address - Fax:254-286-7326
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1433208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE76975Medicare UPIN