Organization
ROUZBEH K KORDESTANI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROUZBEH KHOSROVI KORDESTANI MD PA (OWNER)
(806) 322-5438
Entity
Organization
Contact information
Practice address
3501 SONCY, ST 137, AMARILLO, TX 79119
(806) 322-5438
Mailing address
PO BOX 32901, AMARILLO, TX 79120-2901
(806) 322-5438
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172198701
—
TX
Enumeration date
06/15/2006
Last updated
07/03/2008
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