Provider Demographics
NPI:1114957511
Name:MAHMARIAN, JOHN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:MAHMARIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SMITH TOWER, SUITE 1901
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-1100
Mailing Address - Fax:713-790-2643
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SMITH TOWER, SUITE 1901
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-1100
Practice Address - Fax:713-790-2643
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9767207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX770000927OtherMEDICARE 3
TX00T79SOtherMEDICARE1
TX134999510Medicaid
TX134999511Medicaid
TXP00295327OtherRAILROAD MEDICARE
TXP01036901OtherRR MEDICARE
TX612341OtherMEDICARE 2
TX134999509Medicaid
LA1375250Medicaid
TX8U8373OtherBLUE CROSS BLUE SHIELD
TX612341OtherMEDICARE 2
TX770000927OtherMEDICARE 3
TX8F1438Medicare PIN
TX332670YMVQMedicare PIN
TXP00295327OtherRAILROAD MEDICARE