MEDICARE: HASSAN CHAHADEH I 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	207R00000X	Internal Medicine Physician
2	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1275286635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HASSAN CHAHADEH I PLLC

Provider Business Mailing Address
First Line	:	5225 KATY FWY STE 150
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-2265
Country	:	US
Telephone Number	:	832-582-7269
Fax Number	:

Provider Business Practice Location Address
First Line	:	5225 KATY FWY STE 150
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-2265
Country	:	US
Telephone Number	:	832-582-7269
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	AMIR POURMOGHADDAM
Credential	:
Telephone Number	:	832-582-7269

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	10/01/2024

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