Provider Demographics
NPI:1073113783
Name:TIGER TELEMEDICINE, LLC
Entity Type:Organization
Organization Name:TIGER TELEMEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-821-3436
Mailing Address - Street 1:1107 S WALTER REED DR APT 204
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4371
Mailing Address - Country:US
Mailing Address - Phone:817-821-3436
Mailing Address - Fax:
Practice Address - Street 1:1107 S WALTER REED DR APT 204
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4371
Practice Address - Country:US
Practice Address - Phone:817-821-3436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty