Provider Demographics
NPI:1053585281
Name:MADJIDI, AZITA (MD)
Entity type:Individual
Prefix:DR
First Name:AZITA
Middle Name:
Last Name:MADJIDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 MARONEAL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1219
Mailing Address - Country:US
Mailing Address - Phone:713-838-8276
Mailing Address - Fax:713-666-9106
Practice Address - Street 1:6624 FANNIN ST STE 1600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2328
Practice Address - Country:US
Practice Address - Phone:713-797-1000
Practice Address - Fax:713-795-0949
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL6506208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery