Provider Demographics
NPI:1780446336
Name:FAZLI, SULEMAN
Entity type:Individual
Prefix:
First Name:SULEMAN
Middle Name:
Last Name:FAZLI
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 1:17210 MILRIG CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1719
Mailing Address - Country:US
Mailing Address - Phone:832-566-7196
Mailing Address - Fax:
Practice Address - Street 1:17210 MILRIG CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1719
Practice Address - Country:US
Practice Address - Phone:832-566-7196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program