MEDICARE: TARA RIZVI 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	207RR0500X	Rheumatology Physician	M3073	TX

General Provider Information

NPI Number	:	1467507343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA RIZVI M.D.

Provider Business Mailing Address
First Line	:	14053 MEMORIAL DR UNIT 332
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-6826
Country	:	US
Telephone Number	:	617-947-5619
Fax Number	:	346-202-0088

Provider Business Practice Location Address
First Line	:	23920 KATY FWY STE 440
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-0881
Country	:	US
Telephone Number	:	346-257-4300
Fax Number	:	346-202-0088

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	11/17/2022

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