MEDICARE: MOHSIN IJAZ

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	Q7058	TX
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	CV2103484	IN
3	207RP1001X	Pulmonary Disease Physician	Q7058	TX

General Provider Information

NPI Number	:	1407160369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHSIN IJAZ

Provider Business Mailing Address
First Line	:	PO BOX 468
Second Line	:
City	:	SHANNON
State	:	AL
Zip	:	35142-0468
Country	:	US
Telephone Number	:	205-962-6016
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 E BROAD ST STE 500
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-6416
Country	:	US
Telephone Number	:	682-900-4174
Fax Number	:	682-900-4175

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2010
Last Update Date	:	04/06/2026

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Directions to “ MOHSIN IJAZ ” Practice Location

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