MEDICARE: SYED S AZHAR M.D.

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	J4638	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952479701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED S AZHAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 650859
Second Line	:	DEPT 710
City	:	DALLAS
State	:	TX
Zip	:	75265
Country	:	US
Telephone Number	:	409-772-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 FM 646 RD W STE C
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-3250
Country	:	US
Telephone Number	:	281-614-1256
Fax Number	:	281-614-1587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	03/11/2026

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