Healthcare Provider Details

I. General information

NPI: 1679590533
Provider Name (Legal Business Name): NADEEM HAIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 01/27/2020
Certification Date: 01/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8026 FLOYD CURL DR
SAN ANTONIO TX
78229-3915
US

IV. Provider business mailing address

PO BOX 692371
SAN ANTONIO TX
78269-2371
US

V. Phone/Fax

Practice location:
  • Phone: 210-575-8110
  • Fax:
Mailing address:
  • Phone: 701-566-0617
  • Fax: 210-575-8127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberP1648
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: