Provider Demographics
NPI:1427455195
Name:HIJAZI, FAWZI (BDS,DDS,CDT)
Entity type:Individual
Prefix:DR
First Name:FAWZI
Middle Name:
Last Name:HIJAZI
Suffix:
Gender:M
Credentials:BDS,DDS,CDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E HILDEBRAND AVE # 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-2430
Mailing Address - Country:US
Mailing Address - Phone:210-821-5316
Mailing Address - Fax:210-829-4686
Practice Address - Street 1:235 E HILDEBRAND AVE # 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-2430
Practice Address - Country:US
Practice Address - Phone:210-821-5316
Practice Address - Fax:210-829-4686
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00202435122300000X
TX30682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist