Provider Demographics
NPI:1790073674
Name:KIAMANESH, FOAD (MD)
Entity type:Individual
Prefix:
First Name:FOAD
Middle Name:
Last Name:KIAMANESH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12316 LITTLEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-2313
Mailing Address - Country:US
Mailing Address - Phone:972-333-0802
Mailing Address - Fax:
Practice Address - Street 1:1400 N COIT RD STE 1401
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6660
Practice Address - Country:US
Practice Address - Phone:972-333-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4193208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361403YMR3Medicare UPIN