1750945382 NPI number — AMBER KAZI MD PLLC

Table of content: (NPI 1750945382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750945382 NPI number — AMBER KAZI MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMBER KAZI MD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MEDICE PRIMARY CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750945382
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5710 SAGAMORE BAY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77469-7398
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-816-8716
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17228 W GRAND PKWY S STE 2020
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77479-3688
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-816-8716
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2019

Additional Information

Authorized Official

Authorized Official Last Name:
KAZI
Authorized Official First Name:
AMBER
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
832-816-8716

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P8375 . This is a "LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com