Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | R6390 | TX |
NPI | 1023404316 |
---|---|
Provider Name | Roxana Fatemizadeh |
First Address | Houston, TX 77030-4109 |
Second Address | Houston, TX 77030-2358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 28/10/2021 |