Provider Demographics
NPI:1770582587
Name:HAQUE, MOONA (MD)
Entity type:Individual
Prefix:
First Name:MOONA
Middle Name:
Last Name:HAQUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16651 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2345
Mailing Address - Country:US
Mailing Address - Phone:713-774-5131
Mailing Address - Fax:713-774-4336
Practice Address - Street 1:16651 SOUTHWEST FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2345
Practice Address - Country:US
Practice Address - Phone:713-774-5131
Practice Address - Fax:713-774-4336
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0247207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160050526OtherMEDICARE RR-SL LOCATION
TX160050527OtherMEDICARE RR-SW LOCATION
TX2361214OtherAETNA
TX4526884-003OtherCIGNA
TX8801K0OtherBC/BS
TX0462889-01Medicaid
TX0462889-01Medicaid
TXH21930Medicare UPIN