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General NPI Number Information
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NPI Number | 1104616416
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Entity Type | Organization
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Legal Business Name | SUPERHEALTH MEDICAL PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 5900 S LAKE FOREST DR STE 300
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City | MCKINNEY
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State | TX
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Zip | 75070-2238
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Country | US
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Telephone | 469-833-3592
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Fax | 210-939-4384
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Provider Business Mailing Address
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Address Line | 5900 S LAKE FOREST DR STE 300
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City | MCKINNEY
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State | TX
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Zip | 75070-2238
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Country | US
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Telephone | 469-833-3592
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Fax | 210-939-4384
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Authorized Official
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Title or Position | BUSINESS HEAD
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Name | MR. REHAN EIJAZ
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Credential |
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Telephone | 716-301-2036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NULL
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