Provider Demographics
NPI:1235369307
Name:HAZIN, HESHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:HESHAM
Middle Name:
Last Name:HAZIN
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 3070
Mailing Address - Street 2:STE 238
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75504-3070
Mailing Address - Country:US
Mailing Address - Phone:903-614-5355
Mailing Address - Fax:903-614-5399
Practice Address - Street 1:1000 PINE ST
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-5100
Practice Address - Country:US
Practice Address - Phone:903-614-5580
Practice Address - Fax:903-614-5486
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3885207RH0003X, 207RX0202X
ARE-14666207RH0003X
NY254016207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine