NPIMap

Organization Active NPI

Modern Vein Clinic

  • Cardiovascular Disease Physician
  • Forth Worth, TX
National Provider Identifier
1952820979
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
P7962 Issued in TX
Legal business name
MODERN VEIN CLINIC
Practice address
757 8TH Avenue
Suite a
Forth Worth, TX 76104
Phone
(817) 336-4454
Fax
(817) 336-4440
NPI assigned
Sep 11, 2017
Last updated
Sep 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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

Authorized official

Name
Mr. Michael Nazarian, MDNPI 1245401637
Title
President
Phone
(817) 336-4454

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X P7962 TX Primary

Addresses

Primary practice location

757 8TH Avenue
Suite a
Forth Worth, TX 76104

Mailing address

757 8TH Avenue
Suite a
Forth Worth, TX 76104
Phone (817) 336-4454

National Provider Directory

National Provider Directory

Locations

757 8th Ave
Ste A
Ft Worth, TX 76104
Phone (817) 336-4454

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505088000000",
    "number": "1952820979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 8TH AVENUE",
            "address_2": "SUITE A",
            "city": "FORTH WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-336-4454",
            "fax_number": "817-336-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 8TH AVENUE",
            "address_2": "SUITE A",
            "city": "FORTH WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-336-4454",
            "fax_number": "817-336-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN VEIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A",
        "authorized_official_last_name": "NAZARIAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-336-4454",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "P7962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forth Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.