Individual
DR. SHAYAN ALIREZA IZADDOOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
2727 W HOLCOMBE BLVD, HOUSTON, TX 77025-1669
(713) 442-0000
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
N0850
TX
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
N0850
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204706009
—
TX
05
—
204706010
—
TX
Enumeration date
01/24/2009
Last updated
09/17/2021
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