Healthcare Provider Details

I. General information

NPI: 1730545708
Provider Name (Legal Business Name): RIAZ SHAREEF MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2016
Last Update Date: 01/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 SAN EFRAIN
MISSION TX
78572-3844
US

IV. Provider business mailing address

2603 SAN EFRAIN
MISSION TX
78572-3844
US

V. Phone/Fax

Practice location:
  • Phone: 956-664-9441
  • Fax:
Mailing address:
  • Phone: 956-664-9441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM1441
License Number StateTX

VIII. Authorized Official

Name: RIAZ SHAREEF
Title or Position: OWNER
Credential: MD
Phone: 19566649441