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General NPI Number Information
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NPI Number | 1639435662
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Entity Type | Individual
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Provider Name | GHAZALEH MOAYEDI DO
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Gender | Female
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 1408 N. RIVERFRONT BLVD STE 333
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City | DALLAS
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State | TX
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Zip | 75207
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Country | US
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Telephone | 214-799-1797
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Fax |
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Provider Business Mailing Address
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Address Line | 1408 N. RIVERFRONT BLVD STE 333
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City | DALLAS
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State | TX
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Zip | 75207
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Country | US
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Telephone |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | R6051
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | DOS 1714
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 207VC0300X
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Taxonomy Name | Complex Family Planning Physician
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License Number | R6051
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License Number State | TX
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