Provider Demographics
NPI:1598867749
Name:RAZAVI, MEHDI (MD)
Entity Type:Individual
Prefix:MR
First Name:MEHDI
Middle Name:
Last Name:RAZAVI
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 1:6624 FANNIN
Mailing Address - Street 2:#2480
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2309
Mailing Address - Country:US
Mailing Address - Phone:713-529-5530
Mailing Address - Fax:713-383-0051
Practice Address - Street 1:6624 FANNIN
Practice Address - Street 2:#2480
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2309
Practice Address - Country:US
Practice Address - Phone:713-529-5530
Practice Address - Fax:713-383-0051
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8484207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00261478OtherMCR RAILROAD
TX82T4YYOtherBCBS
G49315Medicare UPIN
TX8B9008Medicare PIN