Organization
MODERN VEIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL NAZARIAN MD (PRESIDENT)
(817) 336-4454
Entity
Organization
Contact information
Practice address
757 8TH AVENUE, SUITE A, FORTH WORTH, TX 76104
(817) 336-4454
(817) 336-4440
Mailing address
757 8TH AVENUE, SUITE A, FORTH WORTH, TX 76104
(817) 336-4454
(817) 336-4440
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
P7962
TX
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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