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General NPI Number Information
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NPI Number | 1053585281
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Entity Type | Individual
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Provider Name | AZITA MADJIDI MD
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Gender | Female
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 6624 FANNIN ST STE 1600
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City | HOUSTON
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State | TX
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Zip | 77030-2328
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Country | US
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Telephone | 713-797-1000
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Fax | 713-795-0949
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Provider Business Mailing Address
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Address Line | 3755 MARONEAL ST
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City | HOUSTON
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State | TX
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Zip | 77025-1219
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Country | US
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Telephone | 713-838-8276
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Fax | 713-666-9106
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | L6506
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License Number State | TX
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