MEDICARE: TAHEREH NAZARI 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
1	390200000X	Student in an Organized Health Care Education/Training Program		TX

General Provider Information

NPI Number	:	1699600106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAHEREH NAZARI MD

Provider Business Mailing Address
First Line	:	6520 MCMAHAN DR
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-1550
Country	:	US
Telephone Number	:	409-974-3388
Fax Number	:

Provider Business Practice Location Address
First Line	:	7616 BRANFORD PL STE 220
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3794
Country	:	US
Telephone Number	:	409-974-3388
Fax Number	:

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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