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General NPI Number Information
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NPI Number | 1790865038
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Entity Type | Individual
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Provider Name | HOMEIRA IZADI MD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 6621 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2303
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Country | US
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Telephone | 832-826-1380
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Fax | 832-825-2799
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Provider Business Mailing Address
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Address Line | 1401 GARCES HWY PO BOX 460
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City | DELANO
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State | CA
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Zip | 93215-3690
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Country | US
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Telephone | 210-586-5815
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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 | 208000000X
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Taxonomy Name | Pediatrics
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License Number | M0067
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License Number State | TX
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