Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1134849 | TX |
NPI | 1003032822 |
---|---|
Provider Name | Fariborz Nezamabadi |
First Address | Houston, TX 77057-5641 |
Second Address | Houston, TX 77057-5641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |