Provider Demographics
NPI:1770738213
Name:MASSOUD BINA
Entity type:Organization
Organization Name:MASSOUD BINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MASSOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:BINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-447-1790
Mailing Address - Street 1:18955 N MEMORIAL DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4271
Mailing Address - Country:US
Mailing Address - Phone:281-446-1790
Mailing Address - Fax:281-446-6903
Practice Address - Street 1:18955 N MEMORIAL DR
Practice Address - Street 2:SUITE 400
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4271
Practice Address - Country:US
Practice Address - Phone:281-446-1790
Practice Address - Fax:281-446-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00F25XMedicare UPIN