Provider Demographics
NPI:1043470297
Name:NOSRATI, NEDA (MD)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:NOSRATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 SAN FELIPE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1780
Mailing Address - Country:US
Mailing Address - Phone:713-952-8400
Mailing Address - Fax:713-952-9448
Practice Address - Street 1:7575 SAN FELIPE ST STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063
Practice Address - Country:US
Practice Address - Phone:713-952-8400
Practice Address - Fax:713-952-9448
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9756207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB159553OtherMEDICARE