Provider Demographics
NPI:1669573531
Name:AZIZ, MOHAMMED HUMAYUN
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:HUMAYUN
Last Name:AZIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 MEDINA DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-6565
Mailing Address - Country:US
Mailing Address - Phone:817-375-8541
Mailing Address - Fax:
Practice Address - Street 1:941 MEDINA DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-6565
Practice Address - Country:US
Practice Address - Phone:817-375-8541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD939502471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography