Provider Demographics
NPI:1417006313
Name:KAHKESHANI, SAEED (MD)
Entity Type:Individual
Prefix:
First Name:SAEED
Middle Name:
Last Name:KAHKESHANI
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 1:4201 GARTH RD
Mailing Address - Street 2:STE 211
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3167
Mailing Address - Country:US
Mailing Address - Phone:281-420-1106
Mailing Address - Fax:281-428-1926
Practice Address - Street 1:4201 GARTH RD
Practice Address - Street 2:STE 211
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3167
Practice Address - Country:US
Practice Address - Phone:281-420-1106
Practice Address - Fax:281-428-1926
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4453174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093805201Medicaid
TX83V951Medicare ID - Type Unspecified
TXB23817Medicare UPIN