Individual
DR. REZA MOBARAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
502 N VALLEY PKWY, STE 2, LEWISVILLE, TX 75067-3437
(972) 316-0902
(972) 316-1161
Mailing address
502 N VALLEY PKWY, STE 2, LEWISVILLE, TX 75067-3437
(972) 316-0902
(972) 316-1161
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1714
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190455902
—
TX
Enumeration date
05/23/2006
Last updated
12/23/2020
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