Healthcare Provider Details

I. General information

NPI: 1912090572
Provider Name (Legal Business Name): SYED M ZAIDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 12/22/2020
Certification Date: 12/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 RIVER POINTE DR STE 120
CONROE TX
77304-2817
US

IV. Provider business mailing address

129 VISION PARK BLVD STE 109
SHENANDOAH TX
77384-3024
US

V. Phone/Fax

Practice location:
  • Phone: 936-756-2555
  • Fax: 936-756-2534
Mailing address:
  • Phone: 936-273-0836
  • Fax: 936-321-2266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number39997
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberN1236
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: