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General NPI Number Information
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NPI Number | 1346596459
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Entity Type | Individual
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Provider Name | RICHARD REZA JAHAN-TIGH M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 6500 WEST LOOP S STE 200F
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City | BELLAIRE
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State | TX
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Zip | 77401-3535
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Country | US
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Telephone | 171-350-0832
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Fax |
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Provider Business Mailing Address
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Address Line | 9226 BEVLYN DR
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City | HOUSTON
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State | TX
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Zip | 77025-4304
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Country | US
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Telephone |
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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 | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | P7290
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | P7290
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License Number State | TX
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