Provider Demographics
NPI:1659938710
Name:AZIZ, MISBAH (FNP-C)
Entity Type:Individual
Prefix:
First Name:MISBAH
Middle Name:
Last Name:AZIZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 N MESA ST APT 2403
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5926
Mailing Address - Country:US
Mailing Address - Phone:469-867-7062
Mailing Address - Fax:
Practice Address - Street 1:200 BARTLETT DR STE 102
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1628
Practice Address - Country:US
Practice Address - Phone:915-228-2992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily