Healthcare Provider Details

I. General information

NPI: 1841722683
Provider Name (Legal Business Name): CYRUS VAHDATPOUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6620 MAIN ST STE 1475
HOUSTON TX
77030-2347
US

IV. Provider business mailing address

7200 CAMBRIDGE ST FL 8
HOUSTON TX
77030-4202
US

V. Phone/Fax

Practice location:
  • Phone: 832-355-2285
  • Fax:
Mailing address:
  • Phone: 832-355-2285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberV2311
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME150264
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberV2311
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: