Provider Demographics
NPI:1508066325
Name:AMIN, TANIA (MD)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 WALNUT HILL LN
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4426
Mailing Address - Country:US
Mailing Address - Phone:214-345-7355
Mailing Address - Fax:214-345-8753
Practice Address - Street 1:8200 WALNUT HILL LN
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4426
Practice Address - Country:US
Practice Address - Phone:214-345-7355
Practice Address - Fax:214-345-8753
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070135362084P0800X
TXP36052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX301654YKQLMedicare PIN
MO152360505Medicare PIN