Individual
SAIRA BANOO MOMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2020 W STATE HIGHWAY 114 STE 340, GRAPEVINE, TX 76051-8650
(817) 410-7700
(817) 410-7720
Mailing address
2020 W STATE HIGHWAY 114 STE 340, GRAPEVINE, TX 76051-8650
(817) 410-7700
(817) 410-7720
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
SL0521
NV
207ND0101X
MOHS-Micrographic Surgery Physician
OS11005
FL
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
P1000
TX
Other
Enumeration date
05/29/2008
Last updated
06/06/2019
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