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NPI Code Detail

MEDICARE: DR. SOGOL PAHLAVAN M.D.

MEDICARE: DR. SOGOL PAHLAVAN 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
1208000000XPediatrics PhysicianM2740TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2M2740OTHERTXLICENSE NUMBER

General Provider Information

NPI Number : 1154418804
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SOGOL PAHLAVAN M.D.
Provider Business Mailing Address
First Line : 13711 WALLISVILLE RD
Second Line :
City : HOUSTON
State : TX
Zip : 77049-3908
Country : US
Telephone Number : 713-455-7777
Fax Number : 713-453-7337
Provider Business Practice Location Address
First Line : 13711 WALLISVILLE RD
Second Line :
City : HOUSTON
State : TX
Zip : 77049-3908
Country : US
Telephone Number : 713-455-7777
Fax Number : 713-453-7337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 06/07/2013

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