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General NPI Number Information
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NPI Number | 1912249053
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Entity Type | Organization
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Legal Business Name | MN COZBY-GERMANY LLC
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 707 N WALDRIP ST
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City | GRAND SALINE
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State | TX
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Zip | 75140-1555
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Country | US
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Telephone | 903-962-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 707 N WALDRIP ST
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City | GRAND SALINE
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State | TX
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Zip | 75140-1555
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Country | US
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Telephone | 903-962-4242
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABBAS RAZA MIAN
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Credential | MD
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Telephone | 903-962-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M4354
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | M8865
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License Number State | TX
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