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Individual

AHMAD GOODARZI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6550 FANNIN ST, SUITE 1101, HOUSTON, TX 77030-2717
(713) 441-0006
(713) 790-2727
Mailing address
6550 FANNIN ST, SUITE 1101, HOUSTON, TX 77030-2717
(713) 441-0006
(713) 790-2727

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
246560
MA
207R00000X
Internal Medicine Physician
P2861
TX
207RP1001X
Pulmonary Disease Physician
Primary
P2861
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
338330902
TX
05
338330903
TX
01
338330904
CSHCN SERVICES PROGRAM
TX
01
8FC773
BLUE CROSS BLUE SHIELD
TX
01
8FX368
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/09/2010
Last updated
10/19/2017
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