Provider Demographics
NPI:1730421165
Name:IQBAL, MEHREEN S (MD)
Entity type:Individual
Prefix:
First Name:MEHREEN
Middle Name:S
Last Name:IQBAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3465 NATIONAL DR STE 105
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-1095
Mailing Address - Country:US
Mailing Address - Phone:214-894-4530
Mailing Address - Fax:214-894-4531
Practice Address - Street 1:3465 NATIONAL DR STE 105
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-1095
Practice Address - Country:US
Practice Address - Phone:214-894-4530
Practice Address - Fax:214-894-4531
Is Sole Proprietor?:No
Enumeration Date:2013-03-24
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT4396207L00000X, 207LP2900X
WI69711207L00000X
MO2019032504207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100079924Medicaid