Provider Demographics
NPI:1780443622
Name:SERIKI, ABDULAZEEZ
Entity type:Individual
Prefix:
First Name:ABDULAZEEZ
Middle Name:
Last Name:SERIKI
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 1:4817 N O CONNOR RD APT 234
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-2207
Mailing Address - Country:US
Mailing Address - Phone:608-658-6221
Mailing Address - Fax:
Practice Address - Street 1:1001 W HIGHWAY 6
Practice Address - Street 2:SUITE 300
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712
Practice Address - Country:US
Practice Address - Phone:254-227-6322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10713372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry