Healthcare Provider Details

I. General information

NPI: 1114159514
Provider Name (Legal Business Name): BILAL HIJAZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 NEW COVINGTON PIKE
MEMPHIS TN
38128-2504
US

IV. Provider business mailing address

3006 GRACE ST APT 2
WICHITA FALLS TX
76302-1575
US

V. Phone/Fax

Practice location:
  • Phone: 901-291-2400
  • Fax:
Mailing address:
  • Phone: 714-519-5635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number44845
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01088591A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number18231
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberQ6325
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: