Provider Demographics
NPI:1154296697
Name:VITALI AZOUZ MD PLLC
Entity type:Organization
Organization Name:VITALI AZOUZ MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:VITALI
Authorized Official - Middle Name:
Authorized Official - Last Name:AZOUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-850-8000
Mailing Address - Street 1:PO BOX 801209
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75380-1209
Mailing Address - Country:US
Mailing Address - Phone:469-507-3446
Mailing Address - Fax:
Practice Address - Street 1:7777 FOREST LN STE 802
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:469-507-3446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty