Provider Demographics
NPI:1356380711
Name:QURESHI, KHUSROO MOHAMMAD (MD)
Entity type:Individual
Prefix:DR
First Name:KHUSROO
Middle Name:MOHAMMAD
Last Name:QURESHI
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:
Practice Address - Street 1:3705 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7753
Practice Address - Country:US
Practice Address - Phone:972-867-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12174207RX0202X
TXN0390207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155217601Medicaid
NHP00185708OtherRAIL ROAD MEDICARE
NH01Y007451NH01OtherBLUE CROSS/BLUE SHIELD
NH1211019OtherCIGNA/HEALTHSOURCE
NH718774OtherCIGNA NATIONAL
NHAA16418OtherHARVARD PILGRIM
TX083503501Medicaid
NH30204446Medicaid
NH5606733OtherCCN HEALTH NETWORK
NH7284653OtherAETNA
TX200784103Medicaid
ME414300099Medicaid
NH5606733OtherMAIL HANDLERS/FIRST HEALT
NH386543OtherMVP HEALTH CARE
NHRE777901Medicare PIN
TX8L1964Medicare PIN
NHI11773Medicare UPIN
TX155217601Medicaid
NH386543OtherMVP HEALTH CARE
TX083503501Medicaid
TX8L1963Medicare PIN