| Syed Mansoor Hussaini Md Pa | |
|
6701 Heritage Pkwy Ste 165 Rockwall TX 75087-8700 | |
| (469) 786-5890 | |
| (469) 786-5780 |
| Full Name | Syed Mansoor Hussaini Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6701 Heritage Pkwy Ste 165, Rockwall, Texas |
| Authorized Official Name and Position | Syed Mansoor Hussaini (DIRECTOR) |
| Authorized Official Contact | 4696151183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Syed Mansoor Hussaini Md Pa Po Box 453202 Garland TX 75045-3202 Ph: (469) 615-1183 | Syed Mansoor Hussaini Md Pa 6701 Heritage Pkwy Ste 165 Rockwall TX 75087-8700 Ph: (469) 786-5890 |
| NPI Number | 1053776856 |
|---|---|
| Provider Enumeration Date | 12/21/2015 |
| Last Update Date | 01/07/2020 |
| Certification Date | 01/07/2020 |
| Medicare PECOS PAC ID | 8224333406 |
|---|---|
| Medicare Enrollment ID | O20160506001485 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053776856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | Q1832 (Texas) | Primary |
| Provider Name | Saud Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821126525 PECOS PAC ID: 3577662808 Enrollment ID: I20101230000419 |
| Provider Name | Syed Hussaini |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881880714 PECOS PAC ID: 2163695966 Enrollment ID: I20141208001462 |
| Provider Name | Tiffany Ann Tackett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295388486 PECOS PAC ID: 7618306259 Enrollment ID: I20200402003551 |
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