MEDICARE: POYAN RAFIEI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	P4697	TX
2	2085R0202X	Diagnostic Radiology Physician	17046C	WY
3	2085R0202X	Diagnostic Radiology Physician	77094	MN
4	2085R0202X	Diagnostic Radiology Physician	MD-53250	IA
5	2085R0202X	Diagnostic Radiology Physician	21172	ND
6	2085R0202X	Diagnostic Radiology Physician	MC-238	GU

General Provider Information

NPI Number	:	1225290380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POYAN RAFIEI M.D.

Provider Business Mailing Address
First Line	:	19826 LANDON BROOK CT
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-1494
Country	:	US
Telephone Number	:	214-886-9338
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 BELLA KATY DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-6819
Country	:	US
Telephone Number	:	214-886-9338
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2008
Last Update Date	:	09/23/2025

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