Provider Demographics
NPI:1144411398
Name:PARS PLASTIC RECONSTRUCTION AND COSMETIC SURGERY PA
Entity Type:Organization
Organization Name:PARS PLASTIC RECONSTRUCTION AND COSMETIC SURGERY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMJADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-465-6198
Mailing Address - Street 1:915 GESSNER RD
Mailing Address - Street 2:STE 870
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2527
Mailing Address - Country:US
Mailing Address - Phone:713-465-6198
Mailing Address - Fax:713-465-6919
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:SUITE 870
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-465-6198
Practice Address - Fax:713-465-6919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8439174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079660901Medicaid
TX00042NMedicare PIN