Healthcare Provider Details

I. General information

NPI: 1881814390
Provider Name (Legal Business Name): MIRZA QASIM HASAN M.D. MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 W JEFFERSON ST
FRANKLIN IN
46131-2140
US

IV. Provider business mailing address

930 FROSTWOOD DR STE 2.200
HOUSTON TX
77024-2450
US

V. Phone/Fax

Practice location:
  • Phone: 317-736-3300
  • Fax:
Mailing address:
  • Phone: 713-338-5502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01095619A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN5712
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberN5712
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01095619A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: