Provider Demographics
NPI: | 1730321712 |
---|---|
Name: | BEHZADI, CHRISTEN FLACK (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | CHRISTEN |
Middle Name: | FLACK |
Last Name: | BEHZADI |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | DR |
Other - First Name: | CHRISTEN |
Other - Middle Name: | JANAE |
Other - Last Name: | FLACK |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | MD |
Mailing Address - Street 1: | PO BOX 650865 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75265-0865 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 972-233-1999 |
Mailing Address - Fax: | 972-233-3666 |
Practice Address - Street 1: | 1500 CITYWEST BLVD |
Practice Address - Street 2: | STE. 300 |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77042-2300 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-620-4000 |
Practice Address - Fax: | 713-458-4229 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2009-04-06 |
Last Update Date: | 2017-02-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | P5334 | 207L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 326120801 | Medicaid | |
TX | 326120802 | Medicaid | |
TX | P01323113 | Other | RR MEDICARE |
TX | 8DZ845 | Other | BLUE CROSS BLUE SHIELD |
TX | 316898YK6U | Medicare PIN |