Provider Demographics
NPI:1508484213
Name:PASSDAR-SHIRAZI, ADRIAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:PASSDAR-SHIRAZI
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1308
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-1300
Mailing Address - Country:US
Mailing Address - Phone:210-614-7953
Mailing Address - Fax:210-614-4190
Practice Address - Street 1:717 GENERATIONS DR STE B
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-0009
Practice Address - Country:US
Practice Address - Phone:844-789-7246
Practice Address - Fax:888-880-9323
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1330708225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist