Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | N9756 | TX |
NPI | 1043470297 |
---|---|
Provider Name | Neda Nosrati |
First Address | Houston, TX 77063-1780 |
Second Address | Houston, TX 77063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 22/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TXB159553 | MEDICARE (01) | TX |