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NPI Code Detail

MEDICARE: IRFAN MANSURI MD

MEDICARE: IRFAN MANSURI MD
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
1207Q00000XFamily Medicine PhysicianL6105TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487740767
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRFAN MANSURI MD
Provider Business Mailing Address
First Line : 11511 SHADOW CREEK PKWY
Second Line :
City : PEARLAND
State : TX
Zip : 77584-7298
Country : US
Telephone Number : 713-442-0000
Fax Number :
Provider Business Practice Location Address
First Line : 5001 E SAM HOUSTON PKWY S
Second Line :
City : PASADENA
State : TX
Zip : 77505-3965
Country : US
Telephone Number : 713-442-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 06/14/2021

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Directions to “ IRFAN MANSURI MD” Practice Location

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