| Davoodi Family Medicine Pa | |
|
3051 Churchill Dr Suite # 100 Flower Mound TX 75022-2713 | |
| (972) 410-3682 | |
| (972) 410-3683 |
| Full Name | Davoodi Family Medicine Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 3051 Churchill Dr, Flower Mound, Texas |
| Authorized Official Name and Position | Fariborz Alan Davoodi (PHYSICIAN) |
| Authorized Official Contact | 9724103682 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Davoodi Family Medicine Pa 3051 Churchill Dr Suite # 100 Flower Mound TX 75022-2713 Ph: (972) 410-3682 | Davoodi Family Medicine Pa 3051 Churchill Dr Suite # 100 Flower Mound TX 75022-2713 Ph: (972) 410-3682 |
| NPI Number | 1174891899 |
|---|---|
| Provider Enumeration Date | 12/08/2011 |
| Last Update Date | 01/25/2012 |
| Medicare PECOS PAC ID | 0244492544 |
|---|---|
| Medicare Enrollment ID | O20120503000082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174891899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | H2930 (Texas) | Primary |
| 261QS1200X | Clinic/center - Sleep Disorder Diagnostic | H2930 (Texas) | Secondary |
| Provider Name | Fariborz A Davoodi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811924343 PECOS PAC ID: 3072539469 Enrollment ID: I20051014000370 |
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