Provider Demographics
NPI:1730308941
Name:GHAZI, ABDOL (DC)
Entity Type:Individual
Prefix:
First Name:ABDOL
Middle Name:
Last Name:GHAZI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 W DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2035
Mailing Address - Country:US
Mailing Address - Phone:956-539-4878
Mailing Address - Fax:936-539-2790
Practice Address - Street 1:3001 W DAVIS ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2035
Practice Address - Country:US
Practice Address - Phone:956-539-4878
Practice Address - Fax:936-539-2790
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4190111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor