Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | L8596 | TX |
Y | 207RI0011X | Interventional Cardiology | L8596 | TX |
NPI | 1114974011 |
---|---|
Provider Name | Dr. Nima Amjadi |
First Address | Austin, TX 78745 |
Second Address | Austin, TX 78745-1157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
167376602 | (05) | TX |
167376603 | (05) | TX |
167376604 | (05) | TX |
167376605 | (05) | TX |
8BX087 | BCBSTX (01) | TX |
H49430 | (02) | TX |
P00334347 | MEDICARE RAILROAD (01) | TX |
P00704409 | RAILROAD MEDICARE (01) | TX |