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General NPI Number Information
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NPI Number | 1184625097
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Entity Type | Individual
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Provider Name | SYED KHAJA AZEEMUDDIN MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 04/22/2010
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Provider Practice Location Address
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Address Line | 10707 W BELLFORT ST
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City | HOUSTON
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State | TX
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Zip | 77099-4748
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Country | US
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Telephone | 281-568-2093
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Fax | 281-568-5967
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Provider Business Mailing Address
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Address Line | 10707 W BELLFORT ST
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City | HOUSTON
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State | TX
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Zip | 77099-4748
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Country | US
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Telephone | 281-568-2093
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Fax | 281-598-7008
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | G1812
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License Number State | TX
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