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NPI Code Detail

MEDICARE: NIZAM PEERWANI MDPA

MEDICARE: NIZAM PEERWANI MDPA
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
1209800000XLegal Medicine (M.D./D.O.) PhysicianE8809TX

General Provider Information

NPI Number : 1316487838
Entity Type Code : Organization
Provider Name (Legal Business Name) : NIZAM PEERWANI MDPA
Provider Business Mailing Address
First Line : 200 FELIKS GWOZDZ PL
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4919
Country : US
Telephone Number : 817-920-5700
Fax Number : 817-496-9641
Provider Business Practice Location Address
First Line : 200 FELIKS GWOZDZ PL
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4919
Country : US
Telephone Number : 817-920-5700
Fax Number : 817-496-9641
Authorized Official
Title or Position : CHIEF MEDICAL EXAMINER
Name : DR. NIZAM PEERWANI
Credential : M.D.
Telephone Number : 817-920-5700
Provider Enumeration Date : 03/02/2017
Last Update Date : 03/02/2017

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Directions to “NIZAM PEERWANI MDPA ” Practice Location

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