Healthcare Provider Details

I. General information

NPI: 1508066325
Provider Name (Legal Business Name): TANIA AMIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 10/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 WALNUT HILL LN DEPARTMENT OF PSYCHIATRY
DALLAS TX
75231-4426
US

IV. Provider business mailing address

8200 WALNUT HILL LN DEPARTMENT OF PSYCHIATRY
DALLAS TX
75231-4426
US

V. Phone/Fax

Practice location:
  • Phone: 214-345-7355
  • Fax: 214-345-8753
Mailing address:
  • Phone: 214-345-7355
  • Fax: 214-345-8753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2007013536
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberP3605
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: