Individual
PAUL TAVAKOLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2425 HIGHWAY 121, BEDFORD, TX 76021-5013
(817) 540-4477
(817) 540-5633
Mailing address
2425 HIGHWAY 121, BEDFORD, TX 76021-5013
(817) 510-4083
(817) 540-5633
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
R6117
TX
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
R6117
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415295101
—
TX
Enumeration date
04/24/2014
Last updated
07/16/2024
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