Provider Demographics
NPI:1962052308
Name:RAZZAK, SOHAIL (APRN)
Entity type:Individual
Prefix:MR
First Name:SOHAIL
Middle Name:
Last Name:RAZZAK
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 GRAPEVINE MILLS PKWY UNIT 1438
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-0905
Mailing Address - Country:US
Mailing Address - Phone:407-446-3072
Mailing Address - Fax:
Practice Address - Street 1:3900 GRAPEVINE MILLS PKWY UNIT 1438
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-0905
Practice Address - Country:US
Practice Address - Phone:407-446-3072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142116363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health