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General NPI Number Information
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NPI Number | 1578752663
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Entity Type | Organization
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Legal Business Name | VA NORTH TEXAS HEALTH CARE SYSTEM
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 6411 FANNIN ST RADIOLOGY, MEMORIAL HERMANN HOSPITAL,
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-704-0100
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Fax | 713-704-5413
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Provider Business Mailing Address
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Address Line | 2701 W BELLFORT ST 308
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City | HOUSTON
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State | TX
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Zip | 77054-5026
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Country | US
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Telephone | 713-244-4835
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Fax | 713-704-5413
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Authorized Official
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Title or Position | PROFESSOR
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Name | DR. NAHID ESHAGHI
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Credential | M.D.
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Telephone | 214-857-0172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number | 4301091015
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License Number State | MI
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