Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 2161 | TX |
NPI | 1356674055 |
---|---|
Provider Name | Tannaz Sedighi |
First Address | Dallas, TX 75252-2698 |
Second Address | Irving, TX 75061-9580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2009 |
Last Update Date | 08/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P01614593 | RAILROAD MEDICARE (01) | TX |