Azizzadeh Fard, Ali
Azizzadeh Fard, Ali is an individual health care provider with primary practice located at 6410 Fannin St 450, Houston TX 77030-3000. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Azizzadeh Fard, Ali can be contacted via phone (713) 500-5304.Contact Information
Primary practice address
6410 Fannin St 450
Houston TX 77030-3000
Phone: (713) 500-5304
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | L5983 | Texas |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | L5983 | Texas |
Profile Details
| NPI number | 1780618918 |
|---|---|
| LBN Legal business name | Azizzadeh Fard, Ali |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Jul 28th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780618918 | NPPES |
| Texas | Other | 166110002 | CSHCN |
| Texas | Other | 8P2580 | CSHCN |
| Texas | MEDICAID | 166110001 | CSHCN |
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