Provider Demographics
NPI:1710365077
Name:AZAR MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:AZAR MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PARVANE
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHIDI-BIRGANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-731-6121
Mailing Address - Street 1:PO BOX 250769
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-0769
Mailing Address - Country:US
Mailing Address - Phone:817-731-6121
Mailing Address - Fax:817-732-8015
Practice Address - Street 1:6913 CAMP BOWIE BLVD
Practice Address - Street 2:SUITE 171
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7163
Practice Address - Country:US
Practice Address - Phone:817-731-6121
Practice Address - Fax:817-732-8015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5897207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty