Provider Demographics
NPI:1912585852
Name:QADRI, RIDA (PA-C)
Entity Type:Individual
Prefix:
First Name:RIDA
Middle Name:
Last Name:QADRI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7619 KINGSRIVER CIR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1485
Mailing Address - Country:US
Mailing Address - Phone:281-825-9352
Mailing Address - Fax:
Practice Address - Street 1:25319 INTERSTATE 45 STE 100
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3551
Practice Address - Country:US
Practice Address - Phone:832-810-0200
Practice Address - Fax:888-682-7273
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA15940363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty