MEDICARE: CARDIAC SPECIALISTS OF HOUSTON, PLLC

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	207RI0011X	Interventional Cardiology Physician	K9583	TX

General Provider Information

NPI Number	:	1821335050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIAC SPECIALISTS OF HOUSTON, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 540088
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77254-0088
Country	:	US
Telephone Number	:	713-850-1190
Fax Number	:	713-850-1327

Provider Business Practice Location Address
First Line	:	6550 FANNIN ST STE 2405
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2742
Country	:	US
Telephone Number	:	832-831-6932
Fax Number	:	832-831-6987

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MASROOR ABDUL QADIR KHAN
Credential	:	MD
Telephone Number	:	713-206-0208

Provider Enumeration Date	:	01/08/2013
Last Update Date	:	05/11/2023

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