Provider Demographics
NPI:1962898312
Name:ROHANI, POOYAN (MD)
Entity type:Individual
Prefix:DR
First Name:POOYAN
Middle Name:
Last Name:ROHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 HALL JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7814
Mailing Address - Country:US
Mailing Address - Phone:817-888-8524
Mailing Address - Fax:817-888-8524
Practice Address - Street 1:1209 HALL JOHNSON RD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7814
Practice Address - Country:US
Practice Address - Phone:817-888-8524
Practice Address - Fax:817-888-8524
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6926207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery