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General NPI Number Information
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NPI Number | 1407160369
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Entity Type | Individual
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Provider Name | MOHSIN IJAZ
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Gender | Male
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 2800 E BROAD ST STE 500
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City | MANSFIELD
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State | TX
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Zip | 76063-6416
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Country | US
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Telephone | 682-900-4174
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Fax | 682-900-4175
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Provider Business Mailing Address
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Address Line | 2800 E BROAD ST STE 500
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City | MANSFIELD
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State | TX
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Zip | 76063-6416
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Country | US
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Telephone | 682-900-4174
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Fax |
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | CV2103484
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | Q7058
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License Number State | TX
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