Healthcare Provider Details

I. General information

NPI: 1952565673
Provider Name (Legal Business Name): GHAZALA M ABUAZZA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 W GRAND PKWY N
KATY TX
77449-2853
US

IV. Provider business mailing address

11511 SHADOW CREEK PKWY
PEARLAND TX
77584-7298
US

V. Phone/Fax

Practice location:
  • Phone: 713-442-4222
  • Fax:
Mailing address:
  • Phone: 713-442-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP5018
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: