Provider Demographics
NPI:1295915205
Name:VAHEDIPOUR, IRAJ (DC)
Entity type:Individual
Prefix:DR
First Name:IRAJ
Middle Name:
Last Name:VAHEDIPOUR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-8008
Mailing Address - Country:US
Mailing Address - Phone:972-503-2273
Mailing Address - Fax:972-503-0336
Practice Address - Street 1:5414 FOREST LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-8008
Practice Address - Country:US
Practice Address - Phone:972-503-2273
Practice Address - Fax:972-503-0336
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor