Provider Demographics
NPI:1053420281
Name:KAMALI, MOJGAN MEGAN (DC)
Entity type:Individual
Prefix:
First Name:MOJGAN
Middle Name:MEGAN
Last Name:KAMALI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 PALM DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248
Mailing Address - Country:US
Mailing Address - Phone:817-491-8566
Mailing Address - Fax:817-491-8566
Practice Address - Street 1:950 S FM 156
Practice Address - Street 2:# 11
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247
Practice Address - Country:US
Practice Address - Phone:940-242-0300
Practice Address - Fax:940-242-0278
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX008852Medicare ID - Type Unspecified
U88487Medicare UPIN
TX8F1835Medicare ID - Type Unspecified