Provider Demographics
NPI:1912180084
Name:AZADI, ROYA A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROYA
Middle Name:A
Last Name:AZADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5902 CANE PACE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1167
Mailing Address - Country:US
Mailing Address - Phone:512-800-7417
Mailing Address - Fax:
Practice Address - Street 1:8000 ANDERSON SQ STE 113
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-8482
Practice Address - Country:US
Practice Address - Phone:512-338-0171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7019207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine