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General NPI Number Information
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NPI Number | 1003245937
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Entity Type | Individual
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Provider Name | MAJID MORIDANI
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Gender | Male
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Dates
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Enumeration Date | 11/01/2013
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 5700 TENNYSON PKWY STE 300
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City | PLANO
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State | TX
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Zip | 75024-3595
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Country | US
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Telephone | 414-949-1355
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 TENNYSON PKWY STE 300
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City | PLANO
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State | TX
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Zip | 75024-3595
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Country | US
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Telephone | 414-949-1355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State |
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