Provider Demographics
NPI:1396739405
Name:AZIM, MOHAMMAD F (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:F
Last Name:AZIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:17448 HIGHWAY 3
Mailing Address - Street 2:STE 200
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4140
Mailing Address - Country:US
Mailing Address - Phone:281-604-1300
Mailing Address - Fax:281-724-0225
Practice Address - Street 1:250 BLOSSOM ST
Practice Address - Street 2:STE 300
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4204
Practice Address - Country:US
Practice Address - Phone:281-604-1300
Practice Address - Fax:281-724-0225
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ3398208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87574ZOtherHMO BLUE
TX045236902Medicaid
TX7492012OtherAETNA
TX8F6720OtherBCBS
TX8404B5Medicare PIN
TX045236902Medicaid