Provider Demographics
NPI:1700088804
Name:KIA, KEVIN FARZIN (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:FARZIN
Last Name:KIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12700 PARK CENTRAL DR STE 1210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-1522
Mailing Address - Country:US
Mailing Address - Phone:214-987-3376
Mailing Address - Fax:469-532-0273
Practice Address - Street 1:1919 S SHILOH RD
Practice Address - Street 2:SUITE 300
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-8234
Practice Address - Country:US
Practice Address - Phone:972-278-4992
Practice Address - Fax:972-271-1597
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN0886207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology