MEDICARE: DR. ALIREZA JAMEOSSANAIE D.C.

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	111N00000X	Chiropractor	10111	TX

General Provider Information

NPI Number	:	1578564308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALIREZA JAMEOSSANAIE D.C.

Provider Business Mailing Address
First Line	:	9111 KATY FWY
Second Line	:	SUITE 226
City	:	HOUSTON
State	:	TX
Zip	:	77024-1648
Country	:	US
Telephone Number	:	713-467-6999
Fax Number	:	270-568-6757

Provider Business Practice Location Address
First Line	:	9111 KATY FWY
Second Line	:	SUITE 226
City	:	HOUSTON
State	:	TX
Zip	:	77024-1648
Country	:	US
Telephone Number	:	713-467-6999
Fax Number	:	270-568-6757

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	05/14/2009

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