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General NPI Number Information
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NPI Number | 1063788446
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Entity Type | Individual
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Provider Name | SHAHEEN KAVOUSSI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 6560 FANNIN ST STE 1812
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City | HOUSTON
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State | TX
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Zip | 77030-2775
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Country | US
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Telephone | 832-306-3209
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Fax | 832-356-5462
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Provider Business Mailing Address
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Address Line | 2117 DEL MONTE DR
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City | HOUSTON
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State | TX
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Zip | 77019-3517
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Country | US
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Telephone | 713-725-8012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 292289-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 01081778A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A154904
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | Q4439
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10041058
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | Q4439
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License Number State | TX
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