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NPI Code Detail

MEDICARE: HAMIDREZA IRANMANESH MD

MEDICARE: HAMIDREZA IRANMANESH 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 PhysicianN3749TX
2390200000XStudent in an Organized Health Care Education/Training ProgramTX
3208M00000XHospitalist PhysicianN3749TX

General Provider Information

NPI Number : 1710189097
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAMIDREZA IRANMANESH MD
Provider Business Mailing Address
First Line : 2601 W LAKE HOUSTON PKWY
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-5222
Country : US
Telephone Number : 281-360-7502
Fax Number : 281-420-2953
Provider Business Practice Location Address
First Line : 2601 W LAKE HOUSTON PKWY
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-5222
Country : US
Telephone Number : 281-360-7502
Fax Number : 281-360-0587
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 09/17/2024

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