MEDICARE: DR. ARAX B NAZARIAN DO

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	207V00000X	Obstetrics & Gynecology Physician	J8444	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8CA717	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1568462414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARAX B NAZARIAN DO

Provider Business Mailing Address
First Line	:	500 W MAIN ST
Second Line	:	#330
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-3629
Country	:	US
Telephone Number	:	972-221-5433
Fax Number	:	972-436-3832

Provider Business Practice Location Address
First Line	:	500 W MAIN ST
Second Line	:	#330
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-3629
Country	:	US
Telephone Number	:	972-221-5433
Fax Number	:	972-436-3832

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	08/25/2009

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