Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | E5296 | TX |
NPI | 1134209547 |
---|---|
Provider Name | Maryam Mortazavi-Zarrabi |
First Address | Houston, TX 77074-5004 |
Second Address | Houston, TX 77074-5004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 25/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
121372002 | (05) | TX |
E41875 | (02) |