MEDICARE: HOUSTON HEART HEALTH PLLC

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	207RC0001X	Clinical Cardiac Electrophysiology Physician

General Provider Information

NPI Number	:	1023891769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON HEART HEALTH PLLC

Provider Business Mailing Address
First Line	:	1140 WESTMONT DR STE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-4368
Country	:	US
Telephone Number	:	713-804-3278
Fax Number	:

Provider Business Practice Location Address
First Line	:	1140 WESTMONT DR STE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-4368
Country	:	US
Telephone Number	:	713-804-3278
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	DR. GHOLAMREZA KHOSHNEVIS
Credential	:	MD
Telephone Number	:	713-804-3278

Provider Enumeration Date	:	08/16/2023
Last Update Date	:	08/16/2023

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