Basic Information
| Provider Information | |||||||||
| NPI: | 1619991296 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALAVI | ||||||||
| FirstName: | AMIR | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6606 LBJ FWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752406524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727155000 | ||||||||
| FaxNumber: | 9727159976 | ||||||||
| Practice Location | |||||||||
| Address1: | 4323 N JOSEY LN STE 107 | ||||||||
| Address2: | |||||||||
| City: | CARROLLTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750104619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9723862020 | ||||||||
| FaxNumber: | 9723862154 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | N4894 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | N4894 | TX | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 286468802 | 05 | TX | MEDICAID | 286468801 | 05 | TX | MEDICAID | 8D8947 | 01 | TX | BCBS | OTHER | P01002868 | 01 | TX | RAILROAD | OTHER | 286468803 | 05 | TX | MEDICAID |