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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780618918 NPPES
Texas Other 166110002 CSHCN
Texas Other 8P2580 CSHCN
Texas MEDICAID 166110001 CSHCN

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