Individual
KAMBIZ JAHADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1402 CHISHOLM TRL STE C, ROUND ROCK, TX 78681-2903
(512) 248-9090
Mailing address
1402 CHISHOLM TRL STE C, ROUND ROCK, TX 78681-2903
(512) 248-9090
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
K6019
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00391G
BCBS IDENTIFIER
TX
05
—
030205101
—
TX
Enumeration date
09/27/2006
Last updated
07/08/2007
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