Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L-248296 | MA |
N | 111NI0900X | Internist | L-248296 | MA |
Y | 207R00000X | Internist | Q0558 | TX |
Y | 111NI0900X | Internist | Q0558 | TX |
NPI | 1003101783 |
---|---|
Provider Name | Zaven Sargsyan |
First Address | Houston, TX 77030-4211 |
Second Address | Houston, TX 77030-4211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2011 |
Last Update Date | 09/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
340792603 | (05) | TX |