1316380934 NPI number — SIMA KAVAND M.D.

Table of content: SIMA KAVAND M.D. (NPI 1316380934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316380934 NPI number — SIMA KAVAND M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAVAND
Provider First Name:
SIMA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316380934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
516 E BYRON NELSON BLVD UNIT 1638
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROANOKE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76262-6269
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-337-6362
Provider Business Mailing Address Fax Number:
214-337-6329

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 W LEBANON STE 208
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75036-3404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-468-9999
Provider Business Practice Location Address Fax Number:
972-981-3600
Provider Enumeration Date:
04/12/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  61093 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: T4945 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)