MEDICARE: DR. KAMBIZ JAHANIAN M.D.

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	2084P0800X	Psychiatry Physician	R5410	TX
2	261QM0850X	Adult Mental Health Clinic/Center	BP10056559	TX

General Provider Information

NPI Number	:	1902255102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMBIZ JAHANIAN M.D.

Provider Business Mailing Address
First Line	:	3139 W HOLCOMBE BLVD STE 120
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1533
Country	:	US
Telephone Number	:	832-345-5539
Fax Number	:	832-365-7992

Provider Business Practice Location Address
First Line	:	3139 W HOLCOMBE BLVD STE 120
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1533
Country	:	US
Telephone Number	:	832-345-5539
Fax Number	:	832-365-7992

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

Provider Enumeration Date	:	06/08/2016
Last Update Date	:	10/28/2025

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