Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | M8951 | TX |
Y | 111NI0900X | Internist | M8951 | TX |
N | 207RH0002X | Hospice and Palliative Medicine | M8951 | TX |
NPI | 1164692026 |
---|---|
Provider Name | Dr. Morvarid Rezaie |
First Address | Fort Worth, TX 76104-2605 |
Second Address | Fort Worth, TX 76104-2605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2008 |
Last Update Date | 17/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1765463 | (05) | TX |
206602904 | (05) | TX |
206602905 | (05) | TX |