Provider Demographics
NPI:1740262823
Name:MOIN, ZAKI (MD)
Entity type:Individual
Prefix:
First Name:ZAKI
Middle Name:
Last Name:MOIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:15200 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3845
Mailing Address - Country:US
Mailing Address - Phone:281-242-5400
Mailing Address - Fax:281-242-5401
Practice Address - Street 1:15200 SOUTHWEST FWY
Practice Address - Street 2:SUITE 240
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3845
Practice Address - Country:US
Practice Address - Phone:281-242-5400
Practice Address - Fax:281-242-5401
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK61602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164284507Medicaid
TXH02524Medicare UPIN
TX164284507Medicaid