Individual
NAZRE MAWLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
—
00AG47
BLUE CROSS BLUE SHIELD
TX
05
—
113985903
—
TX
01
—
118791100
FIRSTCARE
TX
01
—
P00626239
RR MEDICARE
TX
Enumeration date
12/25/2007
Last updated
05/01/2009
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