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General NPI Number Information
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NPI Number | 1609039619
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Entity Type | Individual
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Provider Name | IMTIAZ AHMAD CHAUDHRY MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 6400 FANNIN ST STE 2220
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City | HOUSTON
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State | TX
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Zip | 77030-1536
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Country | US
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Telephone | 832-868-3938
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 FANNIN ST STE 2220
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City | HOUSTON
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State | TX
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Zip | 77030-1536
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Country | US
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Telephone | 832-868-3938
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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 | L2839
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License Number State | TX
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