MEDICARE: ARASH BIDGOLI DO

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	208100000X	Physical Medicine & Rehabilitation Physician	N6180	TX
2	390200000X	Student in an Organized Health Care Education/Training Program

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710177555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARASH BIDGOLI DO

Provider Business Mailing Address
First Line	:	3920 WHEATLAND ROAD, SUITE 134
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3404
Country	:	US
Telephone Number	:	214-941-3192
Fax Number	:	214-941-3762

Provider Business Practice Location Address
First Line	:	3920 WHEATLAND ROAD, SUITE 134
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3404
Country	:	US
Telephone Number	:	214-941-3192
Fax Number	:	214-941-3762

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

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	01/04/2012

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Directions to “ ARASH BIDGOLI DO” Practice Location

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