Provider Demographics
NPI:1659322394
Name:JAHANI, MEHRNOOSH (DO)
Entity Type:Individual
Prefix:DR
First Name:MEHRNOOSH
Middle Name:
Last Name:JAHANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NOOSHI
Other - Middle Name:
Other - Last Name:JAHANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 703196
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75370-3196
Mailing Address - Country:US
Mailing Address - Phone:972-562-9022
Mailing Address - Fax:
Practice Address - Street 1:1100 ALLIED DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5348
Practice Address - Country:US
Practice Address - Phone:214-642-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2490207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114656503Medicaid
TXTXB117159OtherMEDICARE ID
TXTXB117159OtherMEDICARE ID