Provider Demographics
NPI:1275152613
Name:DZALIC, AZRA (FNP-C)
Entity Type:Individual
Prefix:
First Name:AZRA
Middle Name:
Last Name:DZALIC
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 1:6400 FANNIN ST STE 2500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1537
Mailing Address - Country:US
Mailing Address - Phone:713-704-4300
Mailing Address - Fax:713-704-5745
Practice Address - Street 1:6400 FANNIN ST STE 2500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1537
Practice Address - Country:US
Practice Address - Phone:713-704-4300
Practice Address - Fax:713-704-5745
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty