Healthcare Provider Details

I. General information

NPI: 1508356858
Provider Name (Legal Business Name): ANAM AZIMUDDIN MAZHARUDDIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANAM FATIMA AZIMUDDIN MD

II. Dates (important events)

Enumeration Date: 05/12/2018
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5211 FM 2920 RD STE 102
SPRING TX
77388-3004
US

IV. Provider business mailing address

2855 GRAMERCY ST STE 400
HOUSTON TX
77025-1756
US

V. Phone/Fax

Practice location:
  • Phone: 281-444-1677
  • Fax:
Mailing address:
  • Phone: 713-668-6828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberT6963
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: