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Organization

ELITE PRIMARY CARE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ASIF AZIZ MD (PRESIDENT)
(408) 910-0840
Entity
Organization

Contact information

Practice address
4004 MEDICAL PKWY, GREENVILLE, TX 75401-7854
(903) 450-1515
(903) 450-9466
Mailing address
4004 MEDICAL PKWY, GREENVILLE, TX 75401-7854
(903) 450-1515
(903) 450-9466

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
N2391
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
TXB 109980
MEDICARE GROUP PTAN
TX
Enumeration date
06/14/2010
Last updated
12/20/2010
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