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General NPI Number Information
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NPI Number | 1750777579
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Entity Type | Individual
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Provider Name | SINA FAHRTASH MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 6720 BERTNER AVE # MC2-270
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City | HOUSTON
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State | TX
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Zip | 77030-2604
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Country | US
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Telephone | 713-861-7164
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Fax | 713-861-7127
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Provider Business Mailing Address
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Address Line | PO BOX 4346
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City | HOUSTON
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State | TX
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Zip | 77210-4346
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Country | US
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Telephone | 713-861-7164
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Fax | 713-861-7127
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | T1937
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License Number State | TX
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