Provider Demographics
NPI:1821263005
Name:OSTADIAN, MAHAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MAHAN
Middle Name:
Last Name:OSTADIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9707 ANDERSON MILL RD
Mailing Address - Street 2:230
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2298
Mailing Address - Country:US
Mailing Address - Phone:512-219-8787
Mailing Address - Fax:512-219-8788
Practice Address - Street 1:9707 ANDERSON MILL RD
Practice Address - Street 2:230
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2298
Practice Address - Country:US
Practice Address - Phone:512-219-8787
Practice Address - Fax:512-219-8788
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8231207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology