Provider Demographics
NPI:1003841982
Name:HASAN, AZIZA Q (MD)
Entity Type:Individual
Prefix:
First Name:AZIZA
Middle Name:Q
Last Name:HASAN
Suffix:
Gender:F
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:PO BOX 201088
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-1088
Mailing Address - Country:US
Mailing Address - Phone:713-500-3500
Mailing Address - Fax:
Practice Address - Street 1:1602 GARTH RD
Practice Address - Street 2:250
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-2410
Practice Address - Country:US
Practice Address - Phone:281-837-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86655JOtherBCBS
TX86655JMedicare PIN
TX86655JOtherBCBS