Provider Demographics
NPI:1417001694
Name:BORAZJANIAN, GHODRATT (DC)
Entity Type:Individual
Prefix:DR
First Name:GHODRATT
Middle Name:
Last Name:BORAZJANIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 STRATFORD POINTE DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-7321
Mailing Address - Country:US
Mailing Address - Phone:832-242-6402
Mailing Address - Fax:832-242-6564
Practice Address - Street 1:6250 WESTPARK DR STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7384
Practice Address - Country:US
Practice Address - Phone:832-242-6402
Practice Address - Fax:832-242-6564
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7109111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor