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General NPI Number Information
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NPI Number | 1275823346
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Entity Type | Organization
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Legal Business Name | DR REZA IZADI, P.A.
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 3117 DEVONSHIRE DR
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City | PLANO
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State | TX
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Zip | 75075-3374
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Country | US
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Telephone | 972-244-3702
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Fax | 888-394-0177
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Provider Business Mailing Address
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Address Line | 3117 DEVONSHIRE DR
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City | PLANO
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State | TX
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Zip | 75075-3374
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Country | US
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Telephone | 972-244-3702
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Fax | 888-394-0177
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Authorized Official
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Title or Position | PRESIDENT
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Name | REZA IZADI
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Credential | D.O.
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Telephone | 972-244-3702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | N1689
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License Number State | TX
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