Provider Demographics
NPI:1740539196
Name:AZAM, MUHAMMAD OMAR (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:OMAR
Last Name:AZAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1505 LBJ FWY STE 700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-6065
Mailing Address - Country:US
Mailing Address - Phone:214-358-2300
Mailing Address - Fax:214-579-6941
Practice Address - Street 1:13154 COIT RD STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5787
Practice Address - Country:US
Practice Address - Phone:214-358-2300
Practice Address - Fax:214-579-6989
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1495207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR1495OtherTEXAS LICENSE
TXR1495OtherTEXAS LICENSE