1861477150 NPI number — YOUNAN NOWZARADAN MD

Table of content: YOUNAN NOWZARADAN MD (NPI 1861477150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861477150 NPI number — YOUNAN NOWZARADAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NOWZARADAN
Provider First Name:
YOUNAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861477150
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4009 BELLAIRE BLVD
Provider Second Line Business Mailing Address:
SUITE K
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77025-1169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-661-6262
Provider Business Mailing Address Fax Number:
713-661-6611

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4009 BELLAIRE BLVD
Provider Second Line Business Practice Location Address:
SUITE K
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77025-1169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-661-6262
Provider Business Practice Location Address Fax Number:
713-661-6611
Provider Enumeration Date:
12/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  E7211 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 020013047 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 20013047 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8BK950 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 127173601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 86Z693 . This is a "BLUE CROSS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com