Individual
PAYAM GHADERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(823) 355-2666
Mailing address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(823) 355-2666
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
32697617
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/10/2020
Last updated
05/27/2023
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