Provider Demographics
NPI:1922194992
Name:AZIZ, ASIF (MD)
Entity type:Individual
Prefix:
First Name:ASIF
Middle Name:
Last Name:AZIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7854
Mailing Address - Country:US
Mailing Address - Phone:903-450-1515
Mailing Address - Fax:903-450-9466
Practice Address - Street 1:4004 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7854
Practice Address - Country:US
Practice Address - Phone:903-450-1515
Practice Address - Fax:903-450-9466
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2391207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB 109981OtherMEDICARE PTAN
CAH44007Medicare UPIN