MEDICARE: KATTAYOON HASHEMI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	J7511	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0077BS	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1023055522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATTAYOON HASHEMI M.D.

Provider Business Mailing Address
First Line	:	7171 BUFFALO SPEEDWAY
Second Line	:	#1437
City	:	HOUSTON
State	:	TX
Zip	:	77025-1424
Country	:	US
Telephone Number	:	713-667-1287
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 FROSTWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2305
Country	:	US
Telephone Number	:	713-984-0900
Fax Number	:	713-984-1006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	03/05/2008

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