Provider Demographics
NPI:1881697852
Name:HAQUE, RIAZ UL (MD)
Entity type:Individual
Prefix:DR
First Name:RIAZ
Middle Name:UL
Last Name:HAQUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7203 TIMBERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6309
Mailing Address - Country:US
Mailing Address - Phone:504-296-9674
Mailing Address - Fax:504-754-7574
Practice Address - Street 1:2404 SMITH RANCH RD STE 200
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5233
Practice Address - Country:US
Practice Address - Phone:713-436-4333
Practice Address - Fax:844-322-8254
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM5211207Q00000X
LA15040R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA15040ROtherLOUISIANA MEDICAL LICENSE
TX345196501Medicaid
LA1421014Medicaid
TXM5211OtherTEXAS MEDICAL LICENSE