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General NPI Number Information
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NPI Number | 1043524770
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Entity Type | Individual
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Provider Name | SARA MOGHADAM D.C
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Gender | Female
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 3307 BELT LINE RD
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City | GARLAND
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State | TX
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Zip | 75044-6913
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Country | US
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Telephone | 972-496-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 8141 DURHAM DR
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City | FRISCO
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State | TX
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Zip | 75035-7352
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Country | US
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Telephone | 469-231-6784
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 11363
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License Number State | TX
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