Individual
AMIR KHADIVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6431 FANNIN ST, MSB 2.116B, HOUSTON, TX 77030
(713) 500-7643
(713) 383-3710
Mailing address
3305 W LAMAR ST UNIT A, HOUSTON, TX 77019-1915
(601) 946-0962
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
T-4086
MS
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/13/2020
Last updated
06/18/2021
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