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General NPI Number Information
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NPI Number | 1609459239
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Entity Type | Individual
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Provider Name | MOHAMMAD PAKRAVAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2021
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 2660 GULF FWY S
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City | LEAGUE CITY
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State | TX
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Zip | 77573-6820
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Country | US
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Telephone | 832-505-2400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 650859, DEPT DEPT. 710
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City | DALLAS
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State | TX
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Zip | 75265-7101
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Country | US
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Telephone | 409-266-0728
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Fax | 501-526-5148
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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 | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | V5114
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License Number State | TX
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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 | V5114
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License Number State | TX
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