Provider Demographics
NPI:1417319732
Name:AIJAZ, TABISH (MD)
Entity type:Individual
Prefix:
First Name:TABISH
Middle Name:
Last Name:AIJAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3724 FM 1960 RD W STE 337
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3528
Mailing Address - Country:US
Mailing Address - Phone:281-836-5026
Mailing Address - Fax:281-836-5053
Practice Address - Street 1:3724 FM 1960 RD W STE 337
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3528
Practice Address - Country:US
Practice Address - Phone:281-836-5026
Practice Address - Fax:281-836-5053
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036152495207L00000X
NY305291207L00000X
TXU3449207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine