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General NPI Number Information
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NPI Number | 1922379536
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Entity Type | Organization
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Legal Business Name | EAST HOUSTON CARDIOVASCULAR ASSOCIATES PA
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 4201 GARTH RD SUITE 318
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City | BAYTOWN
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State | TX
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Zip | 77521-3167
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Country | US
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Telephone | 713-202-8094
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 GARTH RD SUITE 318
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City | BAYTOWN
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State | TX
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Zip | 77521-3167
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Country | US
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Telephone | 713-202-8094
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GHOLAMREZA KHOSHNEVIS
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Credential | MD
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Telephone | 713-202-8094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | K2228
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License Number State | TX
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