Provider Demographics
NPI:1699018184
Name:VAKHSHOORZADEH, PEYMAUN (MD)
Entity Type:Individual
Prefix:
First Name:PEYMAUN
Middle Name:
Last Name:VAKHSHOORZADEH
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:PEDIATRIC CRITICAL CARE
Mailing Address - Street 2:6411 FANNIN ST
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-500-6443
Mailing Address - Fax:713-486-0989
Practice Address - Street 1:PEDIATRIC CRITICAL CARE
Practice Address - Street 2:6411 FANNIN ST
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-500-6443
Practice Address - Fax:713-486-0989
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT20812080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine