Provider Demographics
NPI:1720118458
Name:SAMANI, KAVEH (MD)
Entity Type:Individual
Prefix:DR
First Name:KAVEH
Middle Name:
Last Name:SAMANI
Suffix:
Gender:M
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:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77237-7174
Mailing Address - Country:US
Mailing Address - Phone:713-222-2238
Mailing Address - Fax:888-972-4675
Practice Address - Street 1:1724 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3604
Practice Address - Country:US
Practice Address - Phone:713-222-2238
Practice Address - Fax:888-972-4675
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7589208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB118409Medicare PIN