Individual
MOHAMMAD R FAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
107 S AVE M, OLNEY, TX 76374
(940) 564-3561
(940) 564-5230
Mailing address
PO BOX 458, 107 S AVE M, OLNEY, TX 76374
(940) 564-3561
(940) 564-5230
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G1003
TX
208600000X
Surgery Physician
Primary
G1003
TX
208D00000X
General Practice Physician
G1003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133873301
—
TX
Enumeration date
02/09/2007
Last updated
10/08/2008
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