Provider Demographics
NPI:1881880714
Name:HUSSAINI, SYED MANSOOR (MD, MPH)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:MANSOOR
Last Name:HUSSAINI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 453202
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75045-3202
Mailing Address - Country:US
Mailing Address - Phone:469-786-5890
Mailing Address - Fax:469-786-5780
Practice Address - Street 1:321 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7378
Practice Address - Country:US
Practice Address - Phone:903-893-5141
Practice Address - Fax:903-891-4285
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ18322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1526111Medicaid
TN103I138291Medicare PIN
TN4308377OtherBLUECROSS