MEDICARE: DR. NASIR HUSSAIN MD

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	207R00000X	Internal Medicine Physician	J5790	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J5790	OTHER	TX	LICENSE

General Provider Information

NPI Number	:	1619148392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NASIR HUSSAIN MD

Provider Business Mailing Address
First Line	:	2109 PLEASANT VALLEY DR
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-4498
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2660 GULF FWY S
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-6820
Country	:	US
Telephone Number	:	832-505-1400
Fax Number	:

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

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	02/15/2022

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