Provider Demographics
NPI:1053846196
Name:HUNDAL, AIZAZ RASHID (MD)
Entity Type:Individual
Prefix:
First Name:AIZAZ
Middle Name:RASHID
Last Name:HUNDAL
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 1:610 CYPRESS TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-1613
Mailing Address - Country:US
Mailing Address - Phone:210-997-3822
Mailing Address - Fax:
Practice Address - Street 1:610 CYPRESS TRL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-1613
Practice Address - Country:US
Practice Address - Phone:210-997-3822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210292302084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology