Provider Demographics
NPI:1134484264
Name:SAADALDIN, MAZIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MAZIN
Middle Name:
Last Name:SAADALDIN
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:PO BOX 844798
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4798
Mailing Address - Country:US
Mailing Address - Phone:806-351-7410
Mailing Address - Fax:806-351-7413
Practice Address - Street 1:1501 S COULTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1770
Practice Address - Country:US
Practice Address - Phone:806-351-7410
Practice Address - Fax:806-351-7413
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-04
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3786207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3481731-01Medicaid
TX3481731-01Medicaid