Individual
DR. OMID FALLAH MEHDIPOUR FARASHTAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7401 W WASHINGTON AVE APT 2047, LAS VEGAS, NV 89128-4314
(858) 776-1933
Mailing address
13201 LEGENDARY DR, APT 4302, AUSTIN, TX 78727-4023
(858) 776-1933
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
31764
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2015
Last updated
10/09/2016
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