Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 19949 | TX |
NPI | 1073736278 |
---|---|
Provider Name | Dr. Dina Anooshiravani |
First Address | Houston, TX 77019-3208 |
Second Address | Houston, TX 77056-1800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2013 |