Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | E9470 | TX |
NPI | 1023039989 |
---|---|
Provider Name | Mr. Mohammade Ebrahim Zafarnia |
First Address | Houston, TX 77055-3028 |
Second Address | Houston, TX 77055-3028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 01/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00B38F | BCBS (01) | TX |
097502101 | (05) | TX |
B27762 | (02) | TX |