Provider Demographics
NPI:1427163286
Name:FIROZ, NAJAM M (MD)
Entity type:Individual
Prefix:
First Name:NAJAM
Middle Name:M
Last Name:FIROZ
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 1:1420 VICEROY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-2208
Mailing Address - Country:US
Mailing Address - Phone:214-358-2300
Mailing Address - Fax:
Practice Address - Street 1:2651 BOLTON BOONE DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2011
Practice Address - Country:US
Practice Address - Phone:214-358-2300
Practice Address - Fax:214-579-6941
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22991207RN0300X
TXQ3182207RN0300X
IA35957207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA41453OtherMEDICARE PTAN
NE098684OtherMEDICARE PTAN
NE086156Medicare PIN
IA41453OtherMEDICARE PTAN
NEP00162102Medicare PIN
IA41947Medicare PIN
NE276581Medicare PIN