Provider Demographics
NPI:1437521119
Name:HAIDER DIAGNOSTIC SERVICES LLC
Entity type:Organization
Organization Name:HAIDER DIAGNOSTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AIJAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-885-7723
Mailing Address - Street 1:2000 CRAWFORD STREET
Mailing Address - Street 2:SUITE 1125
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002
Mailing Address - Country:US
Mailing Address - Phone:281-888-5564
Mailing Address - Fax:281-888-5574
Practice Address - Street 1:2000 CRAWFORD STREET
Practice Address - Street 2:SUITE 1125
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002
Practice Address - Country:US
Practice Address - Phone:281-888-5564
Practice Address - Fax:281-888-5574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
XXX291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory