Provider Demographics
NPI:1255544839
Name:GAHREMANPOUR, AMIR ALI (MD)
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:ALI
Last Name:GAHREMANPOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 GRAHAM DR # B276
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4603
Mailing Address - Country:US
Mailing Address - Phone:832-838-6088
Mailing Address - Fax:832-838-0922
Practice Address - Street 1:27700 NORTHWEST FWY STE 460
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-3341
Practice Address - Country:US
Practice Address - Phone:832-838-6088
Practice Address - Fax:832-838-0922
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM7204207R00000X, 207RI0011X
PAMT185082207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20154928OtherDEPARTMENT OF PUBLIC SAFETY (DPS#)