MEDICARE: ROD FOROOZAN 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	207WX0109X	Neuro-ophthalmology Physician	L5738	TX
2	207W00000X	Ophthalmology Physician	L5738	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8G7722	OTHER	TX	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4278956	OTHER	TX	BLUE LINK
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093704405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROD FOROOZAN M.D.

Provider Business Mailing Address
First Line	:	1977 BUTLER BLVD FL 3
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4101
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1977 BUTLER BLVD FL 3
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4101
Country	:	US
Telephone Number	:	713-798-6100
Fax Number	:

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	12/01/2025

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Directions to “ ROD FOROOZAN M.D.” Practice Location

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