Provider Demographics
NPI:1578906749
Name:ESFANDIARI, FIONA CLAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:FIONA
Middle Name:CLAIRE
Last Name:ESFANDIARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FIONA
Other - Middle Name:CLAIRE
Other - Last Name:NICHOLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12200 RENFERT WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5654
Mailing Address - Country:US
Mailing Address - Phone:512-504-7655
Mailing Address - Fax:
Practice Address - Street 1:12200 RENFERT WAY STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758
Practice Address - Country:US
Practice Address - Phone:512-451-8211
Practice Address - Fax:512-450-1146
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ2036207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program