Healthcare Provider Details

I. General information

NPI: 1578697728
Provider Name (Legal Business Name): MOHAMMAD KHAKPOUR D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13021 COIT RD STE106
DALLAS TX
75240-5789
US

IV. Provider business mailing address

13410 PRESTON RD STE 1-129
DALLAS TX
75240-5299
US

V. Phone/Fax

Practice location:
  • Phone: 972-503-6325
  • Fax: 972-503-1954
Mailing address:
  • Phone: 972-503-6325
  • Fax: 972-503-1954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number7991
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: