Individual provider Active NPI

Maheen Adnan, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1295378701
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9504 Issued in GA
Practice address
6701 Fannin Street
Houston, TX 77030
Phone
(832) 824-1000
NPI assigned
Oct 28, 2019
Reactivated
May 20, 2021
Last updated
May 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9504 GA Primary

Addresses

Primary practice location

6701 Fannin Street
Houston, TX 77030

Mailing address

2405 Holcombe Blvd
Ste NB - 34L
Houston, TX 77021
Phone (832) 828-3660

Other practice location 1

1310 Southern Ave SE
Washington, DC 20032-4623
Phone (202) 574-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9504GAMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1295378701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 HOLCOMBE BLVD",
            "address_2": "STE NB - 34L",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77021",
            "telephone_number": "832-828-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN STREET",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 Southern Ave SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200324623",
            "country_code": "US",
            "telephone_number": "202-574-7070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADNAN",
        "first_name": "MAHEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "deactivation_date": "2021-04-30",
        "reactivation_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.