Provider Demographics
NPI:1124545363
Name:BEHESHTI, ANNAHITA (DMSC, PA-C)
Entity type:Individual
Prefix:
First Name:ANNAHITA
Middle Name:
Last Name:BEHESHTI
Suffix:
Gender:F
Credentials:DMSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8300 N LAMAR BLVD STE 200A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-5976
Mailing Address - Country:US
Mailing Address - Phone:512-782-9312
Mailing Address - Fax:512-782-9316
Practice Address - Street 1:5729 LEBANON RD STE 174
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7259
Practice Address - Country:US
Practice Address - Phone:469-430-1014
Practice Address - Fax:512-782-9316
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP130925363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant