MEDICARE: DR. RAMIN M NIA D.C.

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	111N00000X	Chiropractor	DC9183	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35NR	OTHER	TX	BLUE CROSS/SHIELD PIN

General Provider Information

NPI Number	:	1497753743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMIN M NIA D.C.

Provider Business Mailing Address
First Line	:	3128 FOREST LN
Second Line	:	SUITE 245
City	:	DALLAS
State	:	TX
Zip	:	75234-7726
Country	:	US
Telephone Number	:	972-241-4800
Fax Number	:	972-241-4841

Provider Business Practice Location Address
First Line	:	3128 FOREST LN
Second Line	:	SUITE 245
City	:	DALLAS
State	:	TX
Zip	:	75234-7726
Country	:	US
Telephone Number	:	972-241-4800
Fax Number	:	972-241-4841

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. RAMIN M NIA D.C.” Practice Location

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