# LAILA S TABATABAI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1477788214
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | Q1031 | TX | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |

## Other

- **Enumeration date:** 05/22/2009
- **Last updated:** 05/13/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 341444301 | — | TX |
| 01 | — | 8EQ262 | BLUE CROSS BLUE SHIELD | TX |
| 01 | — | P01403163 | RR MEDICARE | TX |