Individual
ABDOLREZA SIADATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 MISTLETOE BLVD, SUITE 200, FORT WORTH, TX 76104-4014
(817) 878-5333
(817) 878-5334
Mailing address
1900 MISTLETOE BLVD STE 200, FORT WORTH, TX 76104-4049
(817) 878-5333
(817) 878-5334
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
L8956
TX
Other
Enumeration date
07/19/2006
Last updated
02/04/2019
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