MEDICARE: SIAMAK KIANI KEIVAN RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	30856	TX

General Provider Information

NPI Number	:	1215077888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIAMAK KIANI KEIVAN RPH

Provider Business Mailing Address
First Line	:	PO BOX 4850
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79914-4850
Country	:	US
Telephone Number	:	915-400-9900
Fax Number	:	915-400-9600

Provider Business Practice Location Address
First Line	:	9411 DYER ST STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-6407
Country	:	US
Telephone Number	:	915-400-9900
Fax Number	:	915-400-9600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	02/15/2026

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