Healthcare Provider Details

I. General information

NPI: 1407881527
Provider Name (Legal Business Name): NEGAR VAZIRINIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7580 FANNIN ST STE 100
HOUSTON TX
77054-1900
US

IV. Provider business mailing address

7580 FANNIN ST STE 100
HOUSTON TX
77054-1919
US

V. Phone/Fax

Practice location:
  • Phone: 713-807-0029
  • Fax: 713-529-4784
Mailing address:
  • Phone: 713-807-0029
  • Fax: 713-529-4784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberJ5658
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: