Provider Demographics
NPI:1932643970
Name:MAHSA MOSSADEGH MD PLLC
Entity Type:Organization
Organization Name:MAHSA MOSSADEGH MD PLLC
Other - Org Name:NORTH HOUSTON SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSSADEGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-296-7377
Mailing Address - Street 1:9200 PINECROFT DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3279
Mailing Address - Country:US
Mailing Address - Phone:281-296-7377
Mailing Address - Fax:281-296-7255
Practice Address - Street 1:9200 PINECROFT DR
Practice Address - Street 2:SUITE 220
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3279
Practice Address - Country:US
Practice Address - Phone:281-296-7377
Practice Address - Fax:281-296-7255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7059208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX551766Medicare PIN