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General NPI Number Information
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NPI Number | 1558127415
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Entity Type | Organization
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Legal Business Name | LINDSEY TAVAKOLIAN MD PLLC
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Dates
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Enumeration Date | 02/27/2024
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 6110 SHERRY LN
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City | DALLAS
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State | TX
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Zip | 75225-6301
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Country | US
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Telephone | 214-363-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 7047 COMAL DR
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City | IRVING
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State | TX
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Zip | 75039-3316
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Country | US
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Telephone | 678-754-8794
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDSEY TAVAKOLIAN
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Credential | MD
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Telephone | 678-754-8794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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