Basic Information
| Provider Information | |||||||||
| NPI: | 1467458356 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAZHER | ||||||||
| FirstName: | SYED | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O.BOX 84537 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752847208 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6201 HARRY HINES BLVD | ||||||||
| Address2: | |||||||||
| City: | DALLAS, TX 75390 | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75390 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146335555 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2005 | ||||||||
| LastUpdateDate: | 07/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 173000000X | E3012 | AR | N | Other Service Providers | Legal Medicine | 174400000X | E3012 | AR | N | Other Service Providers | Specialist | 207R00000X | E3012 | AR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | E3012 | AR | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 208M00000X | S4022 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RH0003X | S4022 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 143806001 | 05 | AR | MEDICAID | E3012 | 01 | AR | LICENSE NUMBER | OTHER |