Provider Demographics
NPI:1649445107
Name:PEYMAN PAKZABAN, MD PA
Entity type:Organization
Organization Name:PEYMAN PAKZABAN, MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR FINANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:VAUDRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-941-0008
Mailing Address - Street 1:3801 VISTA RD STE 440
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-2162
Mailing Address - Country:US
Mailing Address - Phone:713-941-0008
Mailing Address - Fax:
Practice Address - Street 1:3801 VISTA RD STE 440
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2162
Practice Address - Country:US
Practice Address - Phone:713-941-0008
Practice Address - Fax:713-941-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8305207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BL550OtherBCBS ACCOUNT NUMBER
TXDN4802OtherRAILROAD MEDICARE PART B
TXDN4802OtherRAILROAD MEDICARE PART B