Provider Demographics
NPI:1205124138
Name:FERAIDOON AMINZADEH
Entity type:Organization
Organization Name:FERAIDOON AMINZADEH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FERAIDOON
Authorized Official - Middle Name:
Authorized Official - Last Name:AMINZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-231-2113
Mailing Address - Street 1:8001 LBJ FWY
Mailing Address - Street 2:SUITE 401
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-1337
Mailing Address - Country:US
Mailing Address - Phone:469-231-2113
Mailing Address - Fax:214-269-8855
Practice Address - Street 1:8001 LBJ FWY
Practice Address - Street 2:SUITE 401
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-1337
Practice Address - Country:US
Practice Address - Phone:469-231-2113
Practice Address - Fax:214-269-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty