Provider Demographics
NPI:1184661654
Name:MEGHANI, KARIM (MD)
Entity Type:Individual
Prefix:
First Name:KARIM
Middle Name:
Last Name:MEGHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93267
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-0112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:425 ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-1022
Practice Address - Country:US
Practice Address - Phone:817-820-3502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9205225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4113420OtherBLUE LINK #
TX8050734002OtherCIGNA PAL ID #
TX89Y320OtherHMO BLUE #
TX250007058OtherMEDICARE RAILROAD
TX035953101OtherTPI NUMBER
TX035953101Medicaid
TX5672381OtherAETNA NUMBER
TX4113420OtherBLUE LINK #
TX89Y320OtherHMO BLUE #