=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255620704
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KLAIR MEDICOSE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2011
-----------------------------------------------------
Last Update Date | 09/22/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7798 SPRING VALLEY RD
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75254-2840
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-535-4229
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7798 SPRING VALLEY RD
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75254-2840
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-535-4229
-----------------------------------------------------
Fax | 469-547-1301
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NAVEED AHMAD KLAIR
-----------------------------------------------------
Credential | M.D
-----------------------------------------------------
Telephone | 832-696-5444
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | N7293
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------