Provider Demographics
NPI:1659515807
Name:POUSHESH, MAHMOOD (DC)
Entity Type:Individual
Prefix:
First Name:MAHMOOD
Middle Name:
Last Name:POUSHESH
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 1:9898 BISSONNET
Mailing Address - Street 2:#152
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:713-271-7373
Mailing Address - Fax:713-271-2219
Practice Address - Street 1:9898 BISSONNET
Practice Address - Street 2:#152
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036
Practice Address - Country:US
Practice Address - Phone:713-271-7373
Practice Address - Fax:713-271-2219
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8473111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor