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Contact Information

MOJGAN TAVAKOLI, DPM
4461 COIT RD
SUITE 409
FRISCO, TX75035-0526
 Phone: 972-712-7773
 Fax: 972-712-3134
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for MOJGAN TAVAKOLI · (Female)

NPI Number 1801847694
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 05/15/2006
Last updated 04/10/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • TX License # 1549
  • TX Medicaid 148568201
  • TX Medicaid 148569001
  • TX Other 8B8721 BLUE CROSS BLUE SHIELD
  • TX Other 752946496 COMMERCIAL
Hospital affiliation(s)
  • CENTENNIAL MEDICAL CENTER - (Acute Care)
    12505 LEBANON ROAD
    FRISCO, TX 75035
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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