Individual
GHOLAMREZA KHOSHNEVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4002 GARTH RD STE 110, BAYTOWN, TX 77521-3179
(713) 804-3278
(888) 571-4434
Mailing address
1140 WESTMONT DR STE 320, HOUSTON, TX 77015-4368
(713) 804-3278
(281) 837-7443
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
K2228
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
K2228
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041135701
—
TX
05
—
041135705
—
TX
01
—
8GD673
BCBS
TX
01
—
P01778057
RR MEDICARE
TX
Enumeration date
12/15/2005
Last updated
10/19/2023
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