Provider Demographics
NPI:1831211440
Name:TANVEER A. QURESHI, M.D., P.A.
Entity type:Organization
Organization Name:TANVEER A. QURESHI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FARAZ
Authorized Official - Middle Name:A,
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-566-2358
Mailing Address - Street 1:3304 COLORADO BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6872
Mailing Address - Country:US
Mailing Address - Phone:940-566-2358
Mailing Address - Fax:940-381-2613
Practice Address - Street 1:3304 COLORADO BLVD STE 101
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6872
Practice Address - Country:US
Practice Address - Phone:940-566-2358
Practice Address - Fax:940-381-2613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229039363L00000X
TXE7239207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U74QMedicare ID - Type Unspecified