Provider Demographics
NPI:1619358264
Name:STANAZAI, HASHIM (MD)
Entity Type:Individual
Prefix:
First Name:HASHIM
Middle Name:
Last Name:STANAZAI
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 1:1301 3RD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-2245
Mailing Address - Country:US
Mailing Address - Phone:940-767-5145
Mailing Address - Fax:940-767-3027
Practice Address - Street 1:1000 N SHENANDOAH AVE
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3547
Practice Address - Country:US
Practice Address - Phone:540-636-0300
Practice Address - Fax:540-636-0427
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV29887207P00000X
TXBP10051982207Q00000X
VAFS7258963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAFS7258963OtherDEA