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General NPI Number Information
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NPI Number | 1225076227
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Entity Type | Individual
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Provider Name | RIZWAN HASSAN BUKHARI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 3220 GUS THOMASSON RD STE 231
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City | MESQUITE
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State | TX
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Zip | 75150
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Country | US
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Telephone | 972-885-8346
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Fax | 214-466-1976
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Provider Business Mailing Address
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Address Line | 3220 GUS THOMASSON RD STE 231
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City | MESQUITE
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State | TX
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Zip | 75150-4051
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Country | US
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Telephone | 972-885-8346
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Fax | 214-466-1976
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | J1900
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License Number State | TX
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