Healthcare Provider Details

I. General information

NPI: 1689363947
Provider Name (Legal Business Name): MR. HASSAN QASEEM NAWAZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OCHSNER BLVD
COVINGTON LA
70433-8107
US

IV. Provider business mailing address

108 CHINAWOOD DR
ABITA SPRINGS LA
70420-4017
US

V. Phone/Fax

Practice location:
  • Phone: 985-860-8556
  • Fax:
Mailing address:
  • Phone: 985-860-8556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number350539
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: