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Individual

DR. MOHAMMAD ETMINAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1517 THOMPSON RD, RICHMOND, TX 77469-4932
(281) 344-1715
Mailing address
909 FROSTWOOD DR, SUITE 1.100, HOUSTON, TX 77024-2301
(281) 344-1715

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
L2241
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149358702
TX
05
149358703
TX
05
149358704
TX
05
149358705
TX
05
149358706
TX
01
182635700
US DEPT OF LABOR
TX
01
3471057
AETNA HMO
TX
01
7095249
AETNA PPO
TX
01
8M3060
BLUE CROSS AND BLUE SHIEL
TX
01
P01026731
RAILROAD MEDICARE
TX
Enumeration date
06/22/2005
Last updated
06/28/2012
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