Provider Demographics
NPI:1811094386
Name:YAZDANI, IMRAN A (MD)
Entity type:Individual
Prefix:DR
First Name:IMRAN
Middle Name:A
Last Name:YAZDANI
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 1:4225 WOODS PLACE
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602
Mailing Address - Country:US
Mailing Address - Phone:325-695-3252
Mailing Address - Fax:325-695-3414
Practice Address - Street 1:4225 WOODS PLACE
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602
Practice Address - Country:US
Practice Address - Phone:325-695-3252
Practice Address - Fax:325-695-3414
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine