=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083912828
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOHAMMED SADAT AZIZ D.O
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2011
-----------------------------------------------------
Last Update Date | 10/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4501 JACKSON STREET EXTENSION, STE C-355
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71303-2555
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-621-7161
-----------------------------------------------------
Fax | 318-319-0177
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4501 JACKSON ST EXT STE C355
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71303-2555
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-528-5131
-----------------------------------------------------
Fax | 318-524-7024
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 303703
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------