Provider Demographics
NPI:1700383387
Name:KARAGOZIAN, BRENDA AMAYA (MD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:AMAYA
Last Name:KARAGOZIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11937 US HIGHWAY 271
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75708-3154
Mailing Address - Country:US
Mailing Address - Phone:903-877-7200
Mailing Address - Fax:903-877-5080
Practice Address - Street 1:18118 FM 344 W
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:TX
Practice Address - Zip Code:75762-6010
Practice Address - Country:US
Practice Address - Phone:903-877-7200
Practice Address - Fax:903-877-5080
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6420207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine