Provider Demographics
NPI:1063805406
Name:KAZIM MEDICAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:KAZIM MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAZIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-350-5444
Mailing Address - Street 1:2686 W ALTON GLOOR BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-4054
Mailing Address - Country:US
Mailing Address - Phone:956-350-5444
Mailing Address - Fax:
Practice Address - Street 1:2686 W ALTON GLOOR BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-4054
Practice Address - Country:US
Practice Address - Phone:956-350-5444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8221261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1387771Medicaid
TX1609842509OtherNPI
TXG4819Medicare UPIN
TX1387771Medicaid