Provider Demographics
NPI:1457020927
Name:DURRANI, OMAR (PT, DPT)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:DURRANI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:OMAR
Other - Middle Name:
Other - Last Name:DURRANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:5233 E SOUTHERN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3628
Mailing Address - Country:US
Mailing Address - Phone:480-710-4272
Mailing Address - Fax:
Practice Address - Street 1:5233 E SOUTHERN AVE STE 103
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3628
Practice Address - Country:US
Practice Address - Phone:480-830-2882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ319822251X0800X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic