Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | P3213 | TX |
N | 208000000X | Pediatrician | P3213 | TX |
N | 2080P0203X | Pediatric Critical Care Doctor | P3213 | TX |
NPI | 1104056423 |
---|---|
Provider Name | Proshad Nemati Efune |
First Address | Irving, TX 75063-3526 |
Second Address | Dallas, TX 75235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2009 |
Last Update Date | 14/08/2018 |