Provider Demographics
NPI:1093486268
Name:DARVISHY, MAHNAZ J
Entity Type:Individual
Prefix:
First Name:MAHNAZ
Middle Name:J
Last Name:DARVISHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 WEST GREEN OAKS BLVD, SUITE 305
Mailing Address - Street 2:UNIT 292
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016
Mailing Address - Country:US
Mailing Address - Phone:817-808-7393
Mailing Address - Fax:817-483-4068
Practice Address - Street 1:6601 JOHNS CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-3632
Practice Address - Country:US
Practice Address - Phone:817-808-7393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG