Provider Demographics
NPI:1235236571
Name:GAZI, TAWHID (MD)
Entity Type:Individual
Prefix:
First Name:TAWHID
Middle Name:
Last Name:GAZI
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 1:999 S FAIRMONT AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-5100
Mailing Address - Country:US
Mailing Address - Phone:209-334-8514
Mailing Address - Fax:209-334-0132
Practice Address - Street 1:999 S FAIRMONT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-5100
Practice Address - Country:US
Practice Address - Phone:209-334-8514
Practice Address - Fax:209-334-0132
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4083207RG0100X
MT127341207RG0100X
CA55922207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N59XOtherBCBS OF TEXAS
TX084249401Medicaid
TX084249401Medicaid