Endocrinology and Diabetes Specialist PA

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

M0612 Issued in TX

Legal business name

ENDOCRINOLOGY AND DIABETES SPECIALIST PA

Practice address

11970 N Central Expy
Suite 630
Dallas, TX 75243-3768

Phone

(972) 998-6711

Fax

(972) 421-1677

NPI assigned

Oct 23, 2014

Last updated

Oct 23, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Maryam Zamanian, M.D.NPI 1174508311

Title

Physician Owner

Phone

(972) 998-6711

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maryam Zamanian, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Dallas, TX
  • NPI 1174508311
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1639574403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11970 N CENTRAL EXPY",
            "address_2": "SUITE 630",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433768",
            "telephone_number": "972-998-6711",
            "fax_number": "972-421-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11970 N CENTRAL EXPY",
            "address_2": "SUITE 630",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433768",
            "telephone_number": "972-998-6711",
            "fax_number": "972-421-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY AND DIABETES SPECIALIST PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "ZAMANIAN",
        "authorized_official_first_name": "MARYAM",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "972-998-6711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "M0612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Dallas, TX
• Providers in Dallas, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.