Provider Demographics
NPI:1326220112
Name:AVAZZIA, INC.
Entity Type:Organization
Organization Name:AVAZZIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:B
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-575-2820
Mailing Address - Street 1:13154 COIT RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5787
Mailing Address - Country:US
Mailing Address - Phone:214-575-2820
Mailing Address - Fax:214-575-2824
Practice Address - Street 1:13154 COIT RD STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5787
Practice Address - Country:US
Practice Address - Phone:214-575-2820
Practice Address - Fax:214-575-2824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies