Healthcare Provider Details

I. General information

NPI: 1417962887
Provider Name (Legal Business Name): MUQDAD A ZURIQAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 03/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N HIGHLAND AVE SUITE 455
SHERMAN TX
75092-7388
US

IV. Provider business mailing address

300 N HIGHLAND AVE SUITE 455
SHERMAN TX
75092-7388
US

V. Phone/Fax

Practice location:
  • Phone: 903-868-2800
  • Fax: 903-868-2822
Mailing address:
  • Phone: 903-868-2800
  • Fax: 903-868-2822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberM8455
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: