Individual
AVA HAJIVANDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7777 FOREST LN STE 614, DALLAS, TX 75230-2571
(972) 566-7499
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18009
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/01/2022
Last updated
09/11/2024
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