Provider Demographics
NPI:1003382193
Name:HIJAZI, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HIJAZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 WESTHEIMER RD APT 144
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3069
Mailing Address - Country:US
Mailing Address - Phone:832-230-7896
Mailing Address - Fax:832-615-0459
Practice Address - Street 1:7900 WESTHEIMER RD APT 144
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3069
Practice Address - Country:US
Practice Address - Phone:832-230-7896
Practice Address - Fax:832-615-0459
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health