Healthcare Provider Details

I. General information

NPI: 1891256723
Provider Name (Legal Business Name): QURRAT-UL-AIN AZIZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 19TH ST S
BIRMINGHAM AL
35233-1900
US

IV. Provider business mailing address

1701 W CHARLESTON BLVD STE 230
LAS VEGAS NV
89102-2312
US

V. Phone/Fax

Practice location:
  • Phone: 256-551-4611
  • Fax:
Mailing address:
  • Phone: 702-671-6450
  • Fax: 702-671-2376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number101206
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: