MEDICARE: DR. KARIM AMIR (AMIRGHOLIZADEH) DOCTOR OF CHIROPRACT

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	5221	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8F6348	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1891899969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARIM AMIR (AMIRGHOLIZADEH) DOCTOR OF CHIROPRACT

Provider Business Mailing Address
First Line	:	115 E COLORADO BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75203-1209
Country	:	US
Telephone Number	:	214-948-1849
Fax Number	:	214-943-8465

Provider Business Practice Location Address
First Line	:	115 E COLORADO BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75203-1209
Country	:	US
Telephone Number	:	214-948-1849
Fax Number	:	214-943-8465

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

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	10/06/2015

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