MEDICARE: HUSSAIN HAIDERI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	114014	MO
2	207RN0300X	Nephrology Physician	0430705	KS
3	208M00000X	Hospitalist Physician	R6409	TX
4	207RN0300X	Nephrology Physician	R6409	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063470052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUSSAIN HAIDERI M.D.

Provider Business Mailing Address
First Line	:	2001 N JEFFERSON AVE
Second Line	:
City	:	MOUNT PLEASANT
State	:	TX
Zip	:	75455-2338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 N JEFFERSON AVE
Second Line	:
City	:	MT PLEASANT
State	:	TX
Zip	:	75455-2338
Country	:	US
Telephone Number	:	903-577-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	11/11/2025

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Directions to “ HUSSAIN HAIDERI M.D.” Practice Location

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