MEDICARE: HOOMAN SEDIGHI M.D.

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	225400000X	Rehabilitation Practitioner	J2786	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0035BM	OTHER	TX	BC/BS GROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4418351	OTHER	TX	AETNA
4	84961F	OTHER	TX	BC/BS INDIVIDUAL

General Provider Information

NPI Number	:	1629008941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOOMAN SEDIGHI M.D.

Provider Business Mailing Address
First Line	:	1420 W MOCKINGBIRD LN
Second Line	:	STE. 420
City	:	DALLAS
State	:	TX
Zip	:	75247-4931
Country	:	US
Telephone Number	:	214-267-0101
Fax Number	:	214-267-8787

Provider Business Practice Location Address
First Line	:	1420 W MOCKINGBIRD LN
Second Line	:	STE. 420
City	:	DALLAS
State	:	TX
Zip	:	75247-4931
Country	:	US
Telephone Number	:	214-267-0101
Fax Number	:	214-267-8787

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	08/02/2012

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Directions to “ HOOMAN SEDIGHI M.D.” Practice Location

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