Provider Demographics
NPI:1730155581
Name:HUSSAIN, SUNNY ZAHEED (MD)
Entity type:Individual
Prefix:
First Name:SUNNY
Middle Name:ZAHEED
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1202 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3910
Mailing Address - Country:US
Mailing Address - Phone:318-212-5858
Mailing Address - Fax:318-212-5877
Practice Address - Street 1:2508 BERT KOUN LOOP
Practice Address - Street 2:SUITE 101
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3133
Practice Address - Country:US
Practice Address - Phone:318-212-5858
Practice Address - Fax:318-212-5877
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA2006802080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185905002Medicaid
LA1706523Medicaid
AR164906001Medicaid
AR164906001Medicaid
TX185905002Medicaid