MEDICARE: SYED NASER MUJEEB 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	207Q00000X	Family Medicine Physician	M9517	TX
2	207Q00000X	Family Medicine Physician	036116641	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8DU720	OTHER	TX	BCBSTX

General Provider Information

NPI Number	:	1982709465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED NASER MUJEEB MD

Provider Business Mailing Address
First Line	:	10311 N ELDRIDGE PKWY
Second Line	:	STE B5
City	:	HOUSTON
State	:	TX
Zip	:	77065-5368
Country	:	US
Telephone Number	:	281-890-9822
Fax Number	:	281-890-9844

Provider Business Practice Location Address
First Line	:	10311 N ELDRIDGE PKWY
Second Line	:	STE B5
City	:	HOUSTON
State	:	TX
Zip	:	77065-5368
Country	:	US
Telephone Number	:	281-890-9822
Fax Number	:	281-890-9844

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	10/02/2013

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