Provider Demographics
NPI:1275540007
Name:MIAN, ABBAS R (MD)
Entity Type:Individual
Prefix:DR
First Name:ABBAS
Middle Name:R
Last Name:MIAN
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 1:409 JOPLIN DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-8016
Mailing Address - Country:US
Mailing Address - Phone:903-870-4609
Mailing Address - Fax:903-870-4609
Practice Address - Street 1:5401 BASSWOOD BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-6909
Practice Address - Country:US
Practice Address - Phone:817-945-5500
Practice Address - Fax:817-945-5600
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4354207P00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184767503Medicaid
TX8U3499OtherBCBS
TXTXB125141Medicare Oscar/Certification
TX8K1034Medicare PIN
TXP00441559Medicare PIN
TX8U3499OtherBCBS