Healthcare Provider Details

I. General information

NPI: 1083880959
Provider Name (Legal Business Name): SHIRAZ AHMAD YOUNAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 FANNIN ST SUITE 950
HOUSTON TX
77030-3000
US

IV. Provider business mailing address

6431 FANNIN ST MSB 5.220
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 832-325-7234
  • Fax: 713-512-2221
Mailing address:
  • Phone: 713-500-7398
  • Fax: 713-500-7296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number43571
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberN4217
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: