Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | R6968 | TX |
N | 2086S0122X | Plastic and Reconstructive Surgery | 50213 | AZ |
Y | 2086S0122X | Plastic and Reconstructive Surgery | R6968 | TX |
NPI | 1366838864 |
---|---|
Provider Name | Dr. Solomon Mollik Azouz |
First Address | Dallas, TX 75380-1209 |
Second Address | Dallas, TX 75230-6863 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2015 |
Last Update Date | 02/01/2019 |