MEDICARE: DR. NEDA MEHMANDOOST DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	T60-2014	TX

General Provider Information

NPI Number	:	1710392493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEDA MEHMANDOOST DPM

Provider Business Mailing Address
First Line	:	4543 POST OAK PLACE DR STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-3103
Country	:	US
Telephone Number	:	713-797-1087
Fax Number	:	713-797-9814

Provider Business Practice Location Address
First Line	:	4543 POST OAK PLACE DR STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-3103
Country	:	US
Telephone Number	:	713-797-1087
Fax Number	:	713-797-9814

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

Provider Enumeration Date	:	06/22/2014
Last Update Date	:	03/17/2018

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