Organization
NAZRE MAWLA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAZRE MAWLA MD (OWNER OFFICIER)
(806) 358-1671
Entity
Organization
Contact information
Practice address
1215 S COULTER ST, SUITE 201, AMARILLO, TX 79106-1758
(806) 358-1671
(806) 358-0168
Mailing address
1215 S COULTER ST, SUITE 201, AMARILLO, TX 79106-1758
(806) 358-1671
(806) 358-0168
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G1103
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023SJ
BLUE CROSS BLUE SHIELD GROUP RECORD
TX
01
—
118791100
FIRSTCARE
TX
05
—
208005301
—
TX
01
—
8BF273
BLUE CROSS BLUE SHIELD DR. RECORD
TX
01
—
DO6645
RAILROAD MEDICARE GROUP PTAN
TX
01
—
P00721322
RAILROAD MEDICARE MEMBER PTAN
TX
Enumeration date
10/17/2006
Last updated
05/09/2010
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