Provider Demographics
NPI:1962542498
Name:ISLAM, TANZINA AZIZ (MD)
Entity type:Individual
Prefix:DR
First Name:TANZINA
Middle Name:AZIZ
Last Name:ISLAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TANZINA
Other - Middle Name:A
Other - Last Name:ISLAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11300 CEDARCLIFFE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-3609
Mailing Address - Country:US
Mailing Address - Phone:757-339-9671
Mailing Address - Fax:512-683-2100
Practice Address - Street 1:11500 N MOPAC EXPY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3504
Practice Address - Country:US
Practice Address - Phone:512-683-2273
Practice Address - Fax:512-683-2100
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8052207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine