Healthcare Provider Details

I. General information

NPI: 1861491748
Provider Name (Legal Business Name): AHMAD M HAJJ M.D., F.C.C.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N OREGON ST SUITE 540
EL PASO TX
79902-3584
US

IV. Provider business mailing address

529 SHADOW WILLOW DR
EL PASO TX
79922-1800
US

V. Phone/Fax

Practice location:
  • Phone: 915-351-2300
  • Fax: 915-351-2302
Mailing address:
  • Phone: 915-833-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberK0800
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: