Basic Information
Provider Information
NPI: 1700015625
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NOORUDDIN
FirstName: ZOHRA
MiddleName: IRSHAD
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7979 WURZBACH RD
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782294427
CountryCode: US
TelephoneNumber: 2104501143
FaxNumber: 2104500407
Practice Location
Address1: 7979 WURZBACH RD
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782294427
CountryCode: US
TelephoneNumber: 2104501143
FaxNumber: 2104500407
Other Information
ProviderEnumerationDate: 07/13/2009
LastUpdateDate: 01/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LH0002XN4627TXN Allopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative Medicine
207RH0000XN4627TXN Allopathic & Osteopathic PhysiciansInternal MedicineHematology
207RX0202XN4627TXY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

No ID Information.


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