Provider Demographics
NPI:1033461553
Name:AVESTA MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:AVESTA MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARVANE
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHIDI-BIRGANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-974-4710
Mailing Address - Street 1:PO BOX 250348
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-0348
Mailing Address - Country:US
Mailing Address - Phone:214-974-4710
Mailing Address - Fax:
Practice Address - Street 1:1208 VILLAGE CREEK DR STE 104
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4452
Practice Address - Country:US
Practice Address - Phone:214-974-4710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5897207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1477668275OtherNPI