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General NPI Number Information
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NPI Number | 1699707471
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Entity Type | Organization
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Legal Business Name | S J KECHEJIAN MD PA
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 200 W COLORADO BLVD
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City | DALLAS
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State | TX
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Zip | 75208-2326
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Country | US
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Telephone | 214-946-1177
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Fax | 214-946-1947
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Provider Business Mailing Address
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Address Line | 421 E AIRPORT FWY
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City | IRVING
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State | TX
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Zip | 75062-6319
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Country | US
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Telephone | 972-255-5533
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Fax | 972-256-4099
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SARKIS J KECHEJIAN
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Credential | M.D.
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Telephone | 972-255-5533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | TX
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