Healthcare Provider Details

I. General information

NPI: 1053949529
Provider Name (Legal Business Name): FRAZ HASEEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 11/19/2023
Certification Date: 11/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 E ABRAM ST
ARLINGTON TX
76010-1346
US

IV. Provider business mailing address

4706 ENGLISHTOWN DR
ARLINGTON TX
76016-1880
US

V. Phone/Fax

Practice location:
  • Phone: 682-401-8715
  • Fax:
Mailing address:
  • Phone: 817-939-6047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberU5119
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: