Individual
MOHAMMAD REZA SIADATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2050 HALL JOHNSON RD STE 200, GRAPEVINE, TX 76051-8766
(817) 267-2678
(817) 251-0039
Mailing address
2050 HALL JOHNSON RD STE 200, GRAPEVINE, TX 76051-8766
(817) 267-2678
(817) 251-0039
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M9006
TX
Other
Enumeration date
08/23/2005
Last updated
08/15/2022
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