Individual
SHAMEEM AZIZAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Mailing address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
P9151
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3382491-03
—
TX
05
—
3382491-04
—
TX
05
—
3382491-05
—
TX
01
—
P01482138
RAILROAD MEDICARE
TX
01
—
P01482139
RAILROAD MEDICARE
TX
01
—
P9151
TEXAS MEDICAL LICENSE
TX
Enumeration date
04/21/2009
Last updated
02/14/2017
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