MEDICARE: SHAHRAM NOROUZI SANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD035815	DC
2	207R00000X	Internal Medicine Physician	P6074	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174572077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAHRAM NOROUZI SANI MD

Provider Business Mailing Address
First Line	:	9540 GARLAND RD. #381-251
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-5004
Country	:	US
Telephone Number	:	469-200-4623
Fax Number	:	469-213-2782

Provider Business Practice Location Address
First Line	:	1151 N. BUCKNER BLVD.
Second Line	:	STE. 403
City	:	DALLAS
State	:	TX
Zip	:	75218-3407
Country	:	US
Telephone Number	:	469-200-4623
Fax Number	:	469-213-2782

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	10/23/2023

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Directions to “ SHAHRAM NOROUZI SANI MD” Practice Location

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