Provider Demographics
NPI:1669164497
Name:SAHORI, AMIR NASSIM
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:NASSIM
Last Name:SAHORI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 E STACY RD STE 314
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8738
Mailing Address - Country:US
Mailing Address - Phone:972-678-1277
Mailing Address - Fax:
Practice Address - Street 1:190 E STACY RD STE 314
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8738
Practice Address - Country:US
Practice Address - Phone:972-678-1277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX41524122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program