Provider Demographics
NPI:1891796637
Name:ZAYDMAN, IRINA S (MD)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:S
Last Name:ZAYDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16406 SAGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3914
Mailing Address - Country:US
Mailing Address - Phone:281-499-4371
Mailing Address - Fax:
Practice Address - Street 1:16659 SOUTHWEST FWY
Practice Address - Street 2:SUITE 301
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2375
Practice Address - Country:US
Practice Address - Phone:281-265-2272
Practice Address - Fax:281-491-4181
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2976208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102207104Medicaid
E37367Medicare UPIN