MEDICARE: DR. KARIM HARATIZADEH 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	10054	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9398433	OTHER	TX	PHCS
2	608158	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699802462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARIM HARATIZADEH D.C.

Provider Business Mailing Address
First Line	:	3906 LEMMON AVE
Second Line	:	SUITE 214
City	:	DALLAS
State	:	TX
Zip	:	75219-3734
Country	:	US
Telephone Number	:	214-520-0092
Fax Number	:	214-520-0092

Provider Business Practice Location Address
First Line	:	3906 LEMMON AVE
Second Line	:	SUITE 214
City	:	DALLAS
State	:	TX
Zip	:	75219-3734
Country	:	US
Telephone Number	:	214-520-0092
Fax Number	:	214-520-0092

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/08/2007

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