MEDICARE: AZAR MEDICAL SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	M5897	TX

General Provider Information

NPI Number	:	1710365077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AZAR MEDICAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	PO BOX 250769
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-0769
Country	:	US
Telephone Number	:	817-731-6121
Fax Number	:	817-732-8015

Provider Business Practice Location Address
First Line	:	6913 CAMP BOWIE BLVD
Second Line	:	SUITE 171
City	:	FORT WORTH
State	:	TX
Zip	:	76116-7163
Country	:	US
Telephone Number	:	817-731-6121
Fax Number	:	817-732-8015

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PARVANE RASHIDI-BIRGANI
Credential	:	MD
Telephone Number	:	817-731-6121

Provider Enumeration Date	:	05/07/2015
Last Update Date	:	05/24/2022

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