Provider Demographics
NPI:1790723245
Name:TIRANDAZ, ARASH (MD)
Entity Type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:TIRANDAZ
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 1:6124 W PARKER RD
Mailing Address - Street 2:MOB III SUITE 234
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8124
Mailing Address - Country:US
Mailing Address - Phone:729-468-9999
Mailing Address - Fax:972-981-3600
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:MOB III SUITE 234
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8124
Practice Address - Country:US
Practice Address - Phone:972-981-7500
Practice Address - Fax:972-981-3600
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6768207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0304156-01Medicaid
TX110130494OtherRAILROAD MEDICARE
TX8AW528OtherBCBS
TX5602198OtherAETNA
TXF79991Medicare UPIN
TX0304156-01Medicaid