Individual
DR. MIRZA SHAHBAZ HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8230 WALNUT HILL LN STE 308, DALLAS, TX 75231-4407
(214) 691-8306
(214) 691-3967
Mailing address
8230 WALNUT HILL LN STE 308, DALLAS, TX 75231-4407
(214) 691-8306
(214) 691-3967
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J6480
TX
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
J6480
TX
207RI0200X
Infectious Disease Physician
Primary
J6480
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101889703
—
TX
05
—
101889705
—
TX
05
—
101889706
—
TX
01
—
8B5309
BCBS
TN
01
—
P00250019
RR MEDICARE
TX
Enumeration date
06/30/2006
Last updated
01/13/2015
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