Provider Demographics
NPI:1891899969
Name:AMIR (AMIRGHOLIZADEH), KARIM (DOCTOR OF CHIROPRACT)
Entity Type:Individual
Prefix:DR
First Name:KARIM
Middle Name:
Last Name:AMIR (AMIRGHOLIZADEH)
Suffix:
Gender:M
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:DR
Other - First Name:KARIM
Other - Middle Name:
Other - Last Name:AMIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:115 E COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1209
Mailing Address - Country:US
Mailing Address - Phone:214-948-1849
Mailing Address - Fax:214-943-8465
Practice Address - Street 1:115 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1209
Practice Address - Country:US
Practice Address - Phone:214-948-1849
Practice Address - Fax:214-943-8465
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F6348OtherBCBS
TX603158Medicare ID - Type Unspecified