Individual
DR. PAYAAM PATRICK TAVAKOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4215 JOE RAMSEY BLVD E, GREENVILLE, TX 75401-7852
(903) 408-5000
Mailing address
2500 SUMMER LEE DR APT 440, ROCKWALL, TX 75032-0233
(240) 678-9111
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
T-692058
TX
Other
Enumeration date
07/05/2023
Last updated
07/08/2023
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