Siadati Surgical Consulting LLC
Surgery in Grapevine, TX. Organization (NPI-2).
NPI number1164024170
StatusActive
Last updated in NPPESNov 13, 2020
Details
- NPI
- 1164024170
- Entity type
- Organization (NPI-2)
- Legal business name
- Siadati Surgical Consulting LLC
- Organization subpart
- No
- Enumeration date
- Nov 13, 2020
- Certification date
- Nov 13, 2020
- Last updated
- Nov 13, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | – | – | Yes |
Practice location
2050 Hall Johnson Rd Ste 200Grapevine, TX 76051-8766
Phone 817-267-2678
Mailing address
2050 Hall Johnson Rd Ste 200Grapevine, TX 76051-8766
Authorized official
Mohammad R Siaditi
Owner/Physician
9728903459
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