Moazam PA
Internal Medicine in Thornton, CO. Organization (NPI-2).
NPI number1699043166
StatusActive
Last updated in NPPESJul 18, 2022
Details
- NPI
- 1699043166
- Entity type
- Organization (NPI-2)
- Legal business name
- Moazam PA
- Organization subpart
- No
- Enumeration date
- Dec 12, 2011
- Certification date
- May 27, 2022
- Last updated
- Jul 18, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | N6499 | TX | Yes |
| 207Q00000X | Family Medicine | Q3405 | TX | |
| 208000000X | Pediatrics | N6499 | TX | |
| 2080P0207X | Pediatrics, Pediatric Hematology-Oncology | N6499 | TX |
Other names
- Healthy Horizons Clinic (Doing Business As)
Practice location
1700 W 100th Ave Ste 100Thornton, CO 80260-5982
Phone 915-852-3225
Mailing address
14470 Horizon BlvdSte J
Horizon City, TX 79928-7695
Phone 915-852-3225 · Fax 915-209-8289
Other practice locations
Authorized official
Mustafa Mohammed Moazam
Medical Director
9186919129
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