MEDICARE: SAEED KAHKESHANI MD PA

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	2080P0008X	Pediatric Neurodevelopmental Disabilities Physician
2	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13832514	OTHER	TX	TDL

General Provider Information

NPI Number	:	1497314611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAEED KAHKESHANI MD PA

Provider Business Mailing Address
First Line	:	1010 W BAKER RD STE 104
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77521-2383
Country	:	US
Telephone Number	:	281-427-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 W BAKER RD STE 104
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77521-2383
Country	:	US
Telephone Number	:	281-427-5555
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SAEED KAHKESHANI
Credential	:	MD
Telephone Number	:	281-427-5555

Provider Enumeration Date	:	06/11/2019
Last Update Date	:	05/11/2021

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