Provider Demographics
NPI:1942230149
Name:HOOMAN SEDIGHI, M.D., P.A.
Entity Type:Organization
Organization Name:HOOMAN SEDIGHI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOOMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDIGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-267-0101
Mailing Address - Street 1:1420 W MOCKINGBIRD LN
Mailing Address - Street 2:STE. 420
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4931
Mailing Address - Country:US
Mailing Address - Phone:214-267-0101
Mailing Address - Fax:214-267-8787
Practice Address - Street 1:1420 W MOCKINGBIRD LN
Practice Address - Street 2:STE. 420
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4931
Practice Address - Country:US
Practice Address - Phone:214-267-0101
Practice Address - Fax:214-267-8787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2786225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAETNAOther4418351
TX0035BMOtherBC/BS GROUP #
TX120434903Medicaid
TX84961FOtherBC/BS INDIVIDUAL #
TXF30002Medicare UPIN
TX250003259Medicare ID - Type UnspecifiedMEDICARE RAILROAD
TXAETNAOther4418351
TX84961FOtherBC/BS INDIVIDUAL #