Provider Demographics
NPI:1124516547
Name:BADIYAN ANESTHESIOLOGY PLLC
Entity type:Organization
Organization Name:BADIYAN ANESTHESIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAMIM
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:BADIYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-219-8400
Mailing Address - Street 1:7405 CALLA LILLY LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3813
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4461 COIT RD STE 411
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0526
Practice Address - Country:US
Practice Address - Phone:972-219-8400
Practice Address - Fax:972-219-5331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-01
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty