MEDICARE: HASSAN CHAHADEH

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	208VP0014X	Interventional Pain Medicine Physician	J6083	TX

General Provider Information

NPI Number	:	1114116407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HASSAN CHAHADEH

Provider Business Mailing Address
First Line	:	PO BOX 4346
Second Line	:	DEPT 37
City	:	HOUSTON
State	:	TX
Zip	:	77210-4346
Country	:	US
Telephone Number	:	713-802-9799
Fax Number	:	713-802-1511

Provider Business Practice Location Address
First Line	:	5225 KATY FWY
Second Line	:	#105
City	:	HOUSTON
State	:	TX
Zip	:	77007-2264
Country	:	US
Telephone Number	:	713-802-9799
Fax Number	:	713-802-1511

Authorized Official
Title or Position	:	M D
Name	:	HASSAN CHAHADEH
Credential	:
Telephone Number	:	713-802-9799

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	10/23/2007

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