| Guardian Id Experts, PLLC | |
|
1251 William D Tate Ave Unit 1119 Grapevine TX 76099-4638 | |
| (817) 778-9519 | |
| (817) 796-9340 |
| Full Name | Guardian Id Experts, PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1251 William D Tate Ave Unit 1119, Grapevine, Texas |
| Authorized Official Name and Position | Cima Nowbakht (PHYSICIAN) |
| Authorized Official Contact | 8177789519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guardian Id Experts, PLLC 1251 William D Tate Ave Unit 1119 Grapevine TX 76099-4638 Ph: (817) 778-9519 | Guardian Id Experts, PLLC 1251 William D Tate Ave Unit 1119 Grapevine TX 76099-4638 Ph: (817) 778-9519 |
| NPI Number | 1770426660 |
|---|---|
| Provider Enumeration Date | 04/14/2026 |
| Last Update Date | 04/14/2026 |
| Certification Date | 04/14/2026 |
| Medicare PECOS PAC ID | 1052889987 |
|---|---|
| Medicare Enrollment ID | O20260508000580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770426660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | () | Primary |
| Provider Name | Cima Nowbakht |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1699113910 PECOS PAC ID: 0042569592 Enrollment ID: I20180816003080 |
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