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1205882693

NPI Code Detail

MEDICARE: VALENTINA DOUMANIAN MD

MEDICARE: VALENTINA DOUMANIAN 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	2084P0800X	Psychiatry Physician	63405	MN
2	2084P0800X	Psychiatry Physician	MD187279	OR
3	2084P0800X	Psychiatry Physician	MD60839274	WA
4	2084P0800X	Psychiatry Physician	2019010503	MO
5	2084P0800X	Psychiatry Physician	36524	IA
6	2084P0800X	Psychiatry Physician	86-320	WI
7	2084P0800X	Psychiatry Physician	R6384	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	:	1205882693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALENTINA DOUMANIAN MD

Provider Business Mailing Address
First Line	:	151 175TH AVE E
Second Line	:
City	:	REDINGTON SHORES
State	:	FL
Zip	:	33708-1207
Country	:	US
Telephone Number	:	515-779-6746
Fax Number	:	512-838-4264

Provider Business Practice Location Address
First Line	:	3500 GASTON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2088
Country	:	US
Telephone Number	:	214-820-0111
Fax Number	:

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	06/21/2019

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Directions to “ VALENTINA DOUMANIAN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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