MEDICARE: PEYMAN PAKZABAN, 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	207T00000X	Neurological Surgery Physician	H8305	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DN4802	OTHER	TX	RAILROAD MEDICARE PART B

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8BL550	OTHER	TX	BCBS ACCOUNT NUMBER

General Provider Information

NPI Number	:	1649445107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEYMAN PAKZABAN, MD PA

Provider Business Mailing Address
First Line	:	3801 VISTA RD STE 440
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-2162
Country	:	US
Telephone Number	:	713-941-0008
Fax Number	:

Provider Business Practice Location Address
First Line	:	3801 VISTA RD STE 440
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-2162
Country	:	US
Telephone Number	:	713-941-0008
Fax Number	:	713-941-6262

Authorized Official
Title or Position	:	SENIOR FINANCE COORDINATOR
Name	:	STACI LEE VAUDRIN
Credential	:
Telephone Number	:	713-941-0008

Provider Enumeration Date	:	04/25/2008
Last Update Date	:	10/14/2008

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Directions to “PEYMAN PAKZABAN, MD PA ” Practice Location

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