Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 33761 | TX |
NPI | 1306224993 |
---|---|
Provider Name | Dr. Hasan Zia |
First Address | Richardson, TX 75082-2832 |
Second Address | Richardson, TX 75082-2832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2015 |
Last Update Date | 12/11/2018 |