Provider Demographics
NPI:1578752663
Name:VA NORTH TEXAS HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:VA NORTH TEXAS HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:ESHAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-857-0172
Mailing Address - Street 1:2701 W BELLFORT ST
Mailing Address - Street 2:308
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-5026
Mailing Address - Country:US
Mailing Address - Phone:713-244-4835
Mailing Address - Fax:713-704-5413
Practice Address - Street 1:6411 FANNIN ST
Practice Address - Street 2:RADIOLOGY, MEMORIAL HERMANN HOSPITAL,
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-704-0100
Practice Address - Fax:713-704-5413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091015286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital