Provider Demographics
NPI:1710506803
Name:HOUSTON TEXAS NEUROSURGICAL INSTITUTE. PLLC
Entity Type:Organization
Organization Name:HOUSTON TEXAS NEUROSURGICAL INSTITUTE. PLLC
Other - Org Name:HTNI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:MORADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-464-6245
Mailing Address - Street 1:925 GESSNER RD STE 500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2644
Mailing Address - Country:US
Mailing Address - Phone:713-464-6245
Mailing Address - Fax:713-464-9134
Practice Address - Street 1:925 GESSNER RD STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2644
Practice Address - Country:US
Practice Address - Phone:713-464-6245
Practice Address - Fax:713-464-9134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0950743-02Medicaid
TX10592707OtherCAQH ID