MEDICARE: KHOSROW ALIZADEH

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	344600000X	Taxi	20250634267	TX
2	344600000X	Taxi	801018982	TX

General Provider Information

NPI Number	:	1770374456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHOSROW ALIZADEH

Provider Business Mailing Address
First Line	:	9 SUN VALLEY DR
Second Line	:
City	:	SPRING BRANCH
State	:	TX
Zip	:	78070-7005
Country	:	US
Telephone Number	:	210-422-1238
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 SUN VALLEY DR
Second Line	:
City	:	SPRING BRANCH
State	:	TX
Zip	:	78070-7005
Country	:	US
Telephone Number	:	210-422-1238
Fax Number	:

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

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	01/26/2026

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Directions to “ KHOSROW ALIZADEH ” Practice Location

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