Individual
DR. NIMA PAKZAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-4262
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
583389
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366627304
—
TX
01
—
552843YS6P
MEDICARE
TX
01
—
552843YS6V
MEDICARE
TX
01
—
8JA411
BCBS
TX
01
—
P02013462
MEDICARE RAIL ROAD
TX
01
—
P02056998
MEDICARE RAIL ROAD
TX
Enumeration date
06/19/2014
Last updated
08/21/2018
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