Healthcare Provider Details

I. General information

NPI: 1114116407
Provider Name (Legal Business Name): HASSAN CHAHADEH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 KATY FWY #105
HOUSTON TX
77007-2264
US

IV. Provider business mailing address

PO BOX 4346 DEPT 37
HOUSTON TX
77210-4346
US

V. Phone/Fax

Practice location:
  • Phone: 713-802-9799
  • Fax: 713-802-1511
Mailing address:
  • Phone: 713-802-9799
  • Fax: 713-802-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberJ6083
License Number StateTX

VIII. Authorized Official

Name: HASSAN CHAHADEH
Title or Position: M D
Credential:
Phone: 713-802-9799