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General NPI Number Information
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NPI Number | 1992338370
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Entity Type | Organization
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Legal Business Name | SOUTHEAST TEXAS INFECTIOUS DISEASE PLLC
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 2955 HARRISON ST STE 204
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City | BEAUMONT
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State | TX
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Zip | 77702-1156
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Country | US
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Telephone | 92-454-0761
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Fax | 409-245-0994
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Provider Business Mailing Address
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Address Line | PO BOX 590045
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City | HOUSTON
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State | TX
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Zip | 77259-0045
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Country | US
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Telephone | 281-942-8001
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Fax | 281-724-1919
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Authorized Official
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Title or Position | OWNER
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Name | SHARIQ RAUF
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Credential | MD
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Telephone | 281-942-8001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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