Provider Demographics
NPI:1740252139
Name:RAZA, SYED A (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:A
Last Name:RAZA
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 1:19255 PARK ROW STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7310
Mailing Address - Country:US
Mailing Address - Phone:832-321-5355
Mailing Address - Fax:832-321-5098
Practice Address - Street 1:19255 PARK ROW STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7310
Practice Address - Country:US
Practice Address - Phone:832-321-5355
Practice Address - Fax:832-321-5098
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM02312085R0204X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H71935Medicare UPIN
8G2416Medicare ID - Type Unspecified