Provider Demographics
NPI:1801225289
Name:KADIVAR, ZAHRA
Entity Type:Individual
Prefix:
First Name:ZAHRA
Middle Name:
Last Name:KADIVAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11626 ROYAL OAKS VW
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2842
Mailing Address - Country:US
Mailing Address - Phone:281-459-0098
Mailing Address - Fax:
Practice Address - Street 1:11626 ROYAL OAKS VW
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2842
Practice Address - Country:US
Practice Address - Phone:281-459-0098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12244602251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology