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General NPI Number Information
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NPI Number | 1861711392
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Entity Type | Organization
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Legal Business Name | NOUSHIN IZADIFAR HART, M.D. P.A.
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 10 W WHISTLERS BEND CIR
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City | CONROE
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State | TX
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Zip | 77384-5061
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Country | US
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Telephone | 936-525-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 10 W WHISTLERS BEND CIR
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City | CONROE
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State | TX
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Zip | 77384-5061
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Country | US
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Telephone | 936-525-3900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NOUSHIN IZADIFAR HART
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Credential |
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Telephone | 832-858-5571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number | L5385
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License Number State | TX
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