Healthcare Provider Details

I. General information

NPI: 1033443353
Provider Name (Legal Business Name): GHAZI ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2009
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7701 SAN FELIPE BLVD STE 101
AUSTIN TX
78729-7623
US

IV. Provider business mailing address

7701 SAN FELIPE BLVD STE 101
AUSTIN TX
78729-7623
US

V. Phone/Fax

Practice location:
  • Phone: 512-257-1500
  • Fax:
Mailing address:
  • Phone: 512-257-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number10221
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number10221
License Number StateTX

VIII. Authorized Official

Name: DR. AMIR GHAZI
Title or Position: CEO
Credential: D.C., D.A.C.N.B.
Phone: 512-257-1500