Individual
DR. CHRISTINE MANDANA TAVAKOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1940 ENCHANTED WAY STE 101, GRAPEVINE, TX 76051-0965
(888) 854-1397
(469) 699-0240
Mailing address
1940 ENCHANTED WAY STE 101, GRAPEVINE, TX 76051-0965
(888) 854-1397
(469) 699-0240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OK6263
OK
207Q00000X
Family Medicine Physician
Primary
T3709
TX
Other
Enumeration date
05/02/2016
Last updated
11/07/2021
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