MEDICARE: DR. CYRUS VAHDATPOUR MD

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	207R00000X	Internal Medicine Physician	ME150264	FL
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	V2311	TX
3	390200000X	Student in an Organized Health Care Education/Training Program
4	207RP1001X	Pulmonary Disease Physician	V2311	TX

General Provider Information

NPI Number	:	1841722683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYRUS VAHDATPOUR MD

Provider Business Mailing Address
First Line	:	7200 CAMBRIDGE ST FL 8
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4202
Country	:	US
Telephone Number	:	832-355-2285
Fax Number	:

Provider Business Practice Location Address
First Line	:	6620 MAIN ST STE 1475
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2347
Country	:	US
Telephone Number	:	832-355-2285
Fax Number	:

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

Provider Enumeration Date	:	03/31/2017
Last Update Date	:	09/30/2024

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