MEDICARE: SYED MED SPA LLC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1598500225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYED MED SPA LLC

Provider Business Mailing Address
First Line	:	18484 PRESTON RD STE 301
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-5475
Country	:	US
Telephone Number	:	469-655-3243
Fax Number	:	469-202-2078

Provider Business Practice Location Address
First Line	:	18484 PRESTON RD STE 301
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-5475
Country	:	US
Telephone Number	:	469-655-3243
Fax Number	:	469-202-2078

Authorized Official
Title or Position	:	OWNER
Name	:	SYED HAFEEZ
Credential	:
Telephone Number	:	469-655-3243

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	06/25/2024

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Directions to “SYED MED SPA LLC ” Practice Location

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