Individual
IRAJ ROSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1519 W PANOLA ST, CARTHAGE, TX 75633
(903) 694-2871
(903) 694-2895
Mailing address
PO BOX 847176, DALLAS, TX 75284-7176
(903) 237-1800
(903) 237-1810
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
J8747
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029937202
—
TX
01
—
P00175649
MEDICARE RR
—
Enumeration date
07/04/2006
Last updated
04/12/2013
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