Provider Demographics
NPI:1922626779
Name:ROKNI, MAHDIS (NP)
Entity Type:Individual
Prefix:MISS
First Name:MAHDIS
Middle Name:
Last Name:ROKNI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 GARLAND RD APT 408
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3684
Mailing Address - Country:US
Mailing Address - Phone:214-683-8451
Mailing Address - Fax:
Practice Address - Street 1:1905 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5102
Practice Address - Country:US
Practice Address - Phone:469-290-3240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000946363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily