Provider Demographics
NPI:1861686248
Name:MOEIN, MAHSHID (MD)
Entity Type:Individual
Prefix:MRS
First Name:MAHSHID
Middle Name:
Last Name:MOEIN
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 1:7777 FOREST LN
Mailing Address - Street 2:B116
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2507
Mailing Address - Country:US
Mailing Address - Phone:972-566-8600
Mailing Address - Fax:972-566-8601
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:B116
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2507
Practice Address - Country:US
Practice Address - Phone:972-566-8600
Practice Address - Fax:972-566-8601
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25806208000000X
TXN17772084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics