Organization
MY TRAVEL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOUMAN KIANI M.D. (OWNER)
(317) 438-5529
Entity
Organization
Contact information
Practice address
4902 E THOMPSON RD, INDIANAPOLIS, IN 46237-1905
(317) 438-5529
(317) 438-5929
Mailing address
4902 E THOMPSON RD, INDIANAPOLIS, IN 46237-1905
(317) 438-5529
(317) 438-5929
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
01042881A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200007060
—
IN
Enumeration date
05/10/2017
Last updated
04/29/2020
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