Provider Demographics
NPI:1639135866
Name:IFTIKHAR, HUMA IRFAN (MD)
Entity type:Individual
Prefix:DR
First Name:HUMA
Middle Name:IRFAN
Last Name:IFTIKHAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:840 N ELDRIDGE PKWY
Mailing Address - Street 2:SUITE A-160
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2704
Mailing Address - Country:US
Mailing Address - Phone:281-584-9911
Mailing Address - Fax:281-584-9914
Practice Address - Street 1:4650 WESTWAY PARK BLVD STE 206
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-2006
Practice Address - Country:US
Practice Address - Phone:713-461-2915
Practice Address - Fax:713-461-5307
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL1892173000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX271715Medicare PIN
TXG36789Medicare UPIN