MEDICARE: VIDA AMIN MD

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	208000000X	Pediatrics Physician	M1467	TX

General Provider Information

NPI Number	:	1811956956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIDA AMIN MD

Provider Business Mailing Address
First Line	:	PO BOX 733784
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75373-3784
Country	:	US
Telephone Number	:	682-885-1855
Fax Number	:	682-885-1396

Provider Business Practice Location Address
First Line	:	7120 BOULEVARD 26
Second Line	:
City	:	RICHLAND HILLS
State	:	TX
Zip	:	76180-8608
Country	:	US
Telephone Number	:	817-347-8025
Fax Number	:	817-347-8001

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

Provider Enumeration Date	:	03/18/2006
Last Update Date	:	04/26/2021

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Directions to “ VIDA AMIN MD” Practice Location

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