Provider Demographics
NPI:1053984567
Name:AZIZ, BAHER (NP)
Entity type:Individual
Prefix:MR
First Name:BAHER
Middle Name:
Last Name:AZIZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W CAMP WISDOM RD STE 11
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3342
Mailing Address - Country:US
Mailing Address - Phone:888-854-1397
Mailing Address - Fax:469-699-0243
Practice Address - Street 1:215 W CAMP WISDOM RD STE 11
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3342
Practice Address - Country:US
Practice Address - Phone:888-854-1397
Practice Address - Fax:469-699-0243
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023438363LF0000X
TX1048099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily