Provider Demographics
NPI:1932305638
Name:MED HEALTH CENTER
Entity Type:Organization
Organization Name:MED HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NASSRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOBASHERI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-781-5900
Mailing Address - Street 1:6100 RICHMOND AVE
Mailing Address - Street 2:STE 125
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-6228
Mailing Address - Country:US
Mailing Address - Phone:713-781-5900
Mailing Address - Fax:713-781-0222
Practice Address - Street 1:6100 RICHMOND AVE
Practice Address - Street 2:STE 125
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-6228
Practice Address - Country:US
Practice Address - Phone:713-781-5900
Practice Address - Fax:713-781-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5845207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherFEDERAL TAX ID