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Individual
LAILA S TABATABAI
Active
Individual
LAILA S TABATABAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
Q1031
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341444301
—
TX
01
—
8EQ262
BLUE CROSS BLUE SHIELD
TX
01
—
P01403163
RR MEDICARE
TX
Enumeration date
05/22/2009
Last updated
05/13/2021
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