Individual
DR. NAZRUL ISLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PA.
Contact information
Practice address
1500 W 38TH ST STE 31, AUSTIN, TX 78731-6318
(512) 371-7905
(512) 371-9866
Mailing address
PO BOX 300597, AUSTIN, TX 78703-0010
(512) 371-7905
(512) 371-9866
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L5384
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0056MH
BLUE CROSS BLUE SHIELD ID
TX
01
—
202090270
TAX IDENTIFICATION NUMBER
TX
Enumeration date
08/31/2006
Last updated
10/21/2024
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