Provider Demographics
NPI:1255905758
Name:JAHANGIRI, MARITA (DC)
Entity type:Individual
Prefix:
First Name:MARITA
Middle Name:
Last Name:JAHANGIRI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1656 PRINCE WILLIAM LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6934
Mailing Address - Country:US
Mailing Address - Phone:214-263-0924
Mailing Address - Fax:
Practice Address - Street 1:8240 PRESTON RD STE 165
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2373
Practice Address - Country:US
Practice Address - Phone:214-247-1648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14480111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor