Basic Information
Provider Information
NPI: 1164753679
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIAZ
FirstName: SOHAIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 17500 W GRAND PKWY S
Address2:  
City: SUGAR LAND
State: TX
PostalCode: 774792562
CountryCode: US
TelephoneNumber: 2817255026
FaxNumber: 2817255089
Practice Location
Address1: 4701 OLD SHEPARD PL STE 100
Address2:  
City: PLANO
State: TX
PostalCode: 750935295
CountryCode: US
TelephoneNumber: 2143582300
FaxNumber: 9725992090
Other Information
ProviderEnumerationDate: 01/22/2010
LastUpdateDate: 05/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XN7167TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XN7167TXN Allopathic & Osteopathic PhysiciansHospitalist 
207RN0300XN7167TXY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

ID Information
IDTypeStateIssuerDescription
N716701TXTEXAS LICENSEOTHER


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