MEDICARE: MAZEN AL-ASADI MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	L2783	TX

General Provider Information

NPI Number	:	1295916054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAZEN AL-ASADI MD PA

Provider Business Mailing Address
First Line	:	1140 WESTMONT SUITE 445
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-4366
Country	:	US
Telephone Number	:	713-455-1618
Fax Number	:	713-455-1460

Provider Business Practice Location Address
First Line	:	1140 WESTMONT DR STE 445
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-4368
Country	:	US
Telephone Number	:	713-455-1618
Fax Number	:	713-455-1460

Authorized Official
Title or Position	:	OWNER
Name	:	MAZEN AL-ASADI
Credential	:	MD PA
Telephone Number	:	713-455-1618

Provider Enumeration Date	:	11/21/2007
Last Update Date	:	11/21/2007

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