Provider Demographics
NPI:1942331590
Name:HOOSHYAR, NAHID T (PHD)
Entity Type:Individual
Prefix:DR
First Name:NAHID
Middle Name:T
Last Name:HOOSHYAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6611 CLUBHOUSE CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5448
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:214-378-7009
Practice Address - Street 1:10300 N CENTRAL EXPY
Practice Address - Street 2:SUITE 320
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-8600
Practice Address - Country:US
Practice Address - Phone:972-998-5647
Practice Address - Fax:214-378-7009
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30737101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health