Individual
DR. MOHAMAD ALI AZZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 E MEDICAL CENTER BLVD, WEBSTER, TX 77598-4319
(832) 930-9001
(281) 672-7162
Mailing address
PO BOX 58383, WEBSTER, TX 77598-8383
(832) 930-9001
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
4301106733
MI
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
Q7634
TX
208VP0014X
Interventional Pain Medicine Physician
Q7634
TX
Other
Enumeration date
07/07/2011
Last updated
03/09/2020
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